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Year : 2019  |  Volume : 2  |  Issue : 1  |  Page : 12-16

Early initiation of radiotherapy in patients diagnosed with gliomas: A retrospective analysis of patient in a single institution a tertiary care center

1 Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
2 Department of Neurosurgery, Fortis Memorial Research Institute, Gurgaon, Haryana, India
3 Department of Radiology, Fortis Memorial Research Institute, Gurgaon, Haryana, India

Correspondence Address:
Dr. Anusheel Munshi
Department of Radiation Oncology, Manipal Hospital, Dwarka, New Delhi - 110 075
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJNO.IJNO_1_19

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Objective: Evaluation of effect of interval between surgery to adjuvant radiotherapy (Sx-ART) start and its early tolerance in glioma patients. Method: A retrospective study of 155 adult glioma patients (WHO Grade II-IV) who underwent adjuvant radiotherapy (ART) post-surgery with confirmed histopathology was done in our institution from Sept, 2012 to May,2017. Results were analysed in 3 parts: Sx-ART interval, ART schedule, ART course tolerance. Results: Sx-ART interval ranged from 1-8wks. Seventy-eight percent (121/155) patients started ART within 4wks of surgery, 30/155(19.4%) started within 2wks and 89/155 (57.4%) within 3wks of surgery. ART schedule was conventional fractionation (CF) in 121 (78%) while 34/155 (22%) patients received hypofractionated (HF) course. CF schedules varied between 54Gy-61Gy in 28-33 fractions and HF ranged 50Gy-55Gy in 20-25 fractions. Duration of ART ranged 24-50 days (median 41days). Sixty-five percent (101/155) patients completed ART <6wks and 147/155 (95%) <7wks. Seventy-eight percent (121/155) patients had concurrent Temozolomide (TMZ) including 28/34 (82%) HF patients. ART course interruption was recorded in 11/155 (7%) patients. Interruptions for Sx-ART interval <3wks & >3wks was 3 & 8 patients respectively. None had Grade 3/4 skin reactions or post-treatment scar infection/gaping at ART conclusion. Conclusion: Early start of ART in this analysis showed no difference in tolerance to radiotherapy, including patients receiving HF radiotherapy or concomitant temozolomide. Decrease in time interval from surgery to start of radiotherapy may improve compliance to radiotherapy and reduce overall duration of treatment time (ODT). Long term data of such approaches to reduce ODT and its effect on disease free and overall survival require future studies.

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