Comparative characteristics of patients who received radiation treatment for various pathologies of the central nervous system

ABSTRACT

Introduction: The optimal level of radiation therapy (RT) in the treatment of central nervous system (CNS) tumors ranges between 80-92% in various countries. Despite the successes registered in recent decades in all directions, the prognosis of the outcome of CNS tumors remains pessimistic in most cases.

Purpose: To present a comparative analysis of the patients who received RT due to various tumors of the CNS.

Materials and methods: The present study included the patients who received RT due to CNS tumors in the Radiotherapy department of Fanarjyan National Center of Oncology from 2014 to 2023 and in the Radiotherapy Clinic of “IRA Medical Group” Medical Center from 2018 to 2023. After excluding the patients who did not meet the study criteria, 294 patients (median age, 54.5 years, range, 18-84 years) remained in the final analysis. Of these 294 patients, 227 (77.2%) had characteristics of malignant tumors and 67 (22.8%) had characteristics of benign tumors. In 246 (83.7%) patients, the diagnosis was confirmed by histopathological examination, and in 48 (16.3%) patients, the diagnosis was based on radiological data. According to the clinicohistological characteristics of the tumor, glioblastoma ranked first in 31.98% (n = 94) caes, accounting for 41.4% of all malignant tumors and 45.6% of tumors of glial origin. The next were astrocytomas of different degrees of malignancy – 25.14% (n = 74). Meningiomas accounted for 15.98% (n = 47) cases, of which 30 were benign, accounting for 64.17% of all benign tumors. Patients were distributed almost equally by gender: 49.32% (n = 145) were male and 50.68% (n = 149) were female. The median Karnofsky score of all patients was 80 (range, 50-90). According to the anatomical location in the brain, tumors were most often located in the temporal lobes (n = 103, 35.03%), meninges (n = 47, 15.99%) and frontal lobes (n = 43, 14.63%). The majority of benign tumors (n = 43, 64.18%) were located in the meninges.

Results: The study of preliminary results is encouraging and is in line with global data. However, a final summary of the results is planned after at least 1 year of patient follow-up in 2025. Overall survival, disease-free survival and progression-free survival are planned to be calculated.

Conclusion: The ultimate goal of this study is to optimize approaches to RT of CNS tumors of various origins, taking into account the histological characteristics of the tumor, the treatment received and the RT technique used. It is also planned that after summarizing the data, based on the results obtained, risk factors and prognostic factors will be identified for choosing the optimal tactics and method of treatment, which will be presented in the form of a methodological manual.