Efficacy of post-operative treatment with concurrent chemoradiation for high-grade gliomas

Objective: To analyze the efficacy of post-operative treatment with intensity modulated radiation therapy(IMRT) plus temozolomide for high-grade gliomas.Methods: From January 2005 to December 2009,53 patients with high-grade cerebral gliomas received post-operative treatment with IMRT plus temozolomide with simultaneous boosted radiation technique.The prescribed dose of planning target volume 2(PTV2) was 50.4 Gy/28f,and PTV1,PTVtb,and PGTV were 58.8 Gy/28f,61.6 Gy/28f,and 64.4 Gy/28f,respectively.Concurrent chemotherapy was performed with oral temozolomide 75 mg·m-2 daily at the initiation of radiation.Patients rested for 4 weeks after the completion of radiation.Then patients received four-cycles of oral chemotherapy(28 days for each cycle).Temozolomide was administered orally at 150 mg·m-2 daily for continuous 5 days in the first cycle of chemotherapy,and its dose was increased to 200 mg·m-2 daily in the latter three-cycle chemotherapy.Toxicities were observed and recorded,and overall survival and local-progress free survival rate were calculated.Results: Most acute toxicities were grade 1 or 2,and no grade 4 toxicities occurred.Late cerebral radiation necrosis occurred in 3 patients.The rates of 1-,2-,and 3-year overall survival were 75.5%,52.8% and 39.6%;and the rates of 1-,2-,and 3-year local-progress free survival were 67.9%,45.3%,and 35.8%,respectively.Conclusion: Ideal clinical efficacy has been acquired for high-grade cerebral gliomas after receiving post-operative treatment with IMRT plus temozolomide,the acute toxicities are minor,and the late side reactions are receptive.