A survival analysis of high-grade gliomas in sub-himalayan population including the times of lockdown during COVID 19 pandemic: A single institutional experience
Background and Objectives: High Grade Gliomas are categorised as Grade III and IV and have high mortality rate with poor prognosis. How we should adopt clinical practice in neuro-oncology during Covid 19 Pandemic is another area of scientific exploration . Hypofractionated radiotherapy protocols can be easily utilised in high grade gliomas during Covid 19 pandemic .
Materials and Methods: Retrospective analysis of 147 patients with diagnosis of high-grade gliomas between January 2009 till December 2020 including Covid-19 pandemic lockdown time was done. Age , gender , KPS , symptoms , extent of surgery and use of concurrent temozolamide , were evaluated using univariate and multivariate analysis .Overall Survival was determined using the Kaplan Meir method .
Results: Glioblastoma multiforme being the most common brain tumor (82.3%) in all high-grade gliomas .Near total or total excision was done in 83.7% of cases The median dose of EBRT delivered was 60Gy .75.5% patients were treated with concurrent and adjuvant chemotherapy . 29.2% patients were treated during Covid 19 pandemic lockdown time . The median overall survival was 15.9 months . The 1 year Overall survival was 67.8% , and 3 year OS was 6.4% . Out of 43 patients treated during covid pandemic time ,62.7% are alive and on follow up .
Conclusion: The results of survival analysis demonstrated the benefit of adding radiation with concurrent and adjuvant temzolamide in high grade gliomas including covid 19 during lockdown time . Hypofractionated radiotherapy with concurrent temozolamide is safe during the Covid 19 pandemic
