OBJECTIVE

To determine significant factors influencing treatment results, as well as to select the optimal approach to treatment tactics for patients with progression of anaplastic astrocytomas of the brain.

MATERIAL AND METHODS

The study included 60 patients who were treated in the period from 2006 to 2021 in the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine. The average age of the patients was 42.9±12.2 years. The male to female ratio is 1.5:1. The main treatment methods were a combination of surgical treatment with chemotherapy with temozolomide (10 people) and radiation therapy (8 people); monochemotherapy with temozolomide (12 people); 23 people received radiation therapy and 7 people received chemoradiation therapy.

RESULTS

The median overall survival (OS) of patients was 48 months, 1-year OS rates were 94.7%; 2-year OS — 78.6%; 3-year OS — 63.7%, 5-year OS — 37.4%. Median progression-free survival (PFS) after treatment of relapse was 24 months.

The median OS in patients operated on after the development of relapse was 58 months, while without surgery it was 48 months, the difference was not statistically significant. At the same time, the best PFS rates were observed with reoperation followed by radiation therapy — 35 months, as well as with radiation without surgery — 24 months. (p=0.897). Among radiotherapy techniques, the best OS and PFS rates were observed in patients who underwent courses of combined photon-neutron therapy — 84 months. and 47 months respectively.

CONCLUSION

Thus, factors positively influencing the rates of OS and VBP include repeated surgical treatment and combined neutron-photon therapy. Repeated course of combined photon-neutron therapy may be a necessary component of treatment of this category of patients.