الفهرس 
Introduction and aim of the work
Patients and methodsOnly 14 pages are availabe for public view
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Abstract
This study was performed on 66 patients with high grade brain glioma, who were referred to Clinical Oncology and Nuclear Medicine department, Mansoura University Hospiatl, during the period from July 1999 through Dec. 2002. The aim of this study was to evaluate the effect of hyperfractionated radiotherapy on overall survival and progression free survival of patients with high grade glioma of brain. ??The median age of our patients was 50 years and maleto female ratio was 1.3:1. ??Symptoms of high ICT were the most common presentation. ??Parietal lobe was the most commonly involved site. Most tumors occupied more than one lobe. ??Glioblastoma multiform represented the commonest histopathological variant in our study, followed by anaplastic astrocytoma.??The commonest surgical procedure done for our patients was biopsy (50%) while gross total excision was applicable only in 24.2% of patients. ??Regarding clinical response, group I (HFRT) patients had higher rates of CR and PR than patients in group II (CFRT). However, the difference was statistically insignificant. ??Complete radiological response was evident in 45.1% of patients in group I and PR in 16.2%, while in group II, CR was shown in 22.9% and PR in 17.1% but the difference was not statistically significant. ??On studying the effect of patients? characteristics and tumors? characteristics on survival, and PFS performance status, tumor histopathology and tumor grade, and extent of surgical resection were strong prognostic factors influencing survival of all patients. While age, sex, tumor size and tumor location did not exert significant influence on survival.??On comparing the results of treatment by different techniques, there was a trend for longer survival and PFS favoring patients in group I although the results were not statistically significant. However, we failed to demonstrate statistical significant difference between both regimens. ??Studies are ongoing on malignant glioma to escalate the radiation dose using interstitial branchytherapy, stereotactic radiosurgery and three dimensional conformal radiation therapy. However, it is unlikely that such intensification would produce a major break through or even modest increase in survival of this disease.??Again, extensive surgical resection (greater than 95%) of Malignant glioma in many cases result in an improvement of symptoms and response to radiotherapy. ??Clever attempts at novel experimental therapeutic approaches designed with the aim of killing neoplastic cells via stimulating the immune system to reject the tumor, transfer lethal genes to the tumor cells with gene therapy or more recently, to infect with viruses that kill the tumor cells lytically.