Hypofractionated Radiotherapy Versus Conventional Radiotherapy in Management of Patients with High Grade Gliomas Older Patients and Poor Performance State

Abstract

Gliomas are the most common primary intracranial tumor, Glioblastoma, the most common glioma histology 45% of all gliomas, Glioblastoma multiform is aggressive tumor with dismal prognosis, the median survival were 14.6 month with concurrent chemoradiotherapy in patients younger than 70 and good performance patients. Age and performance status consider the most important prognostic factor for glioblastoma, elderly and Karnofsky performance score <70 associated with significant reduction in survival. Older and frail patients are usually suffered from comorbidity and need help in daily life activities. And usually cannot withstand the standard concurrent chemoradiotherapy, conventional radiotherapy over 6 weeks become a burden over the patient, family and health care givers. In literatures short course of radiotherapy has been studied and it was not inferior to conventional course in survival benefit in frail patients. With obvious advantage i