Clinical Features, Management and Outcomes of high-grade glioma patients in Ramathibodi Hospital
Phichai Chansriwong MD*, Thitiya Sirisinha MD**
Affiliation : * Department of Medicine, Faculty of medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Bangkok, Thailand **Department of Medicine, Faculty of medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To identify prognostic factors for survival and evaluate the effect of treatment on survival of patients
with high-grade glioma treated at Ramathibodi Hospital.
Material and Method: Medical records of patients with diagnosis of high-grade glioma registered in
Ramathibodi cancer registry were reviewed. A total of 36 patients were reviewed, only 27 patients were
included on survival analysis.
Results : Of the 36 patients, the male: female ratio was 1:1. Mean age of diagnosis was 41.86 years (range 18-
71 years). Histological findings were anaplastic glioma (22.20%), glioblastoma multiforme (63.90%) and
mixed glioma (13.90%). Of fifteen patients underwent total tumor removal, 17 patients had partial resection
and in 4 cases biopsy alone was done. Two third of the patients had received radiotherapy with mean total
dose 5,372 cGy. Nine patients also received chemotherapy (6 temozolomide and 3 BCNU). Median follow-up
time was 413.2 days. An overall survival time was 604.04 days and median disease free survival time was
402.45 days. In univariated analysis, the following favorable prognostic factors were identified: histological
findings of glioblastoma multiforme (GBM) and mixed glioma, received radiotherapy. In multivariate analysis,
radiotherapy improves overall survival significantly. Re-resection at recurrence did not appear to improve
overall survival.
Conclusion : Adult high-grade glioma had poor prognosis despite aggressive treatment. Radiotherapy signifi-
cantly improved survival while surgical tumor removal and chemotherapy did not. However due to the small
number of patients the further studies should be performed.
Keywords : Malignant Glioma, Temozolomide
