Transition from 2D conventional to 3d conformal radiation therapy in patients with brain gliomas: clinical outcome (Mansoura University).

Background And Objectives: Radiotherapy became an important component in the treatment of brain gliomas either high grade or low grade. This study was conducted to evaluate the efficacy and safety of the three-dimensional conformal radiotherapy and compare this results with two-dimensional conventional radiotherapy in patients with brain gliomas.

Patients And Methods: Sixty patients with histologically proven brain gliomas between November 2007 and december 2009, were enrolled in this study. They were 25 with low grade and 35 with high grade, treated in our department according to a three-dimensional conformal radiotherapy; patients received a total irradiation dose of 54-60 GY, 2 GY/day, 5 days/week, were enrolled prospectively (arm I). The patients under study were compared to 120 patients (44 low grade and 76 high grade) who received irradiation with 2 D-conventional radiotherapy and were served as a retrospective study (arm II). The overall survival and progression free survival times were estimated using Kaplan-Meier method and the prognostic factors were analyzed with log-rank test. Acute and late toxicity evaluated using the Swog Scoring.

Results: During the follow-up period (median 12.5 months ranged 8-24 months) the median overall survival and progression free survival times were 14 and 6 months respectively. There was no statistically significant differences as regard survival between both arms. In univariate analysis, age, grade of the tumors and type of surgery were important prognostic factorsr. Regarding late complication of radiotherapy, there were significant differences in MRI encephalomalcia between both groups (30%Vs. 69.2%) in arm I and arm II respectively.

Conclusion: Concerning the tumor control and survival rate, the three-dimensional treatment planning shows no advantages compared to the standard two dimensional conventional methods. The main advantage of the 3-DCRT is the possibility to spare normal brain tissue.