CLINICAL OUTCOMES AND SURVIVAL BENEFITS OF RADICAL RADIOTHERAPY COMBINED WITH TEMOZOLOMIDE IN PATIENTS WITH HIGH-GRADE BRAIN TUMORS

Abstract

Background: High-grade brain tumors, particularly glioblastoma multiforme and anaplastic astrocytoma, are highly aggressive malignancies with poor prognosis despite advances in multimodal therapy. Radical radiotherapy combined with temozolomide remains the standard treatment; however, survival outcomes and treatment response vary significantly due to tumor biology and patient-related factors.

Objective: This study aimed to evaluate the clinical outcomes and survival benefits of radical radiotherapy combined with temozolomide in patients with high-grade brain tumors.

Methods: A quantitative observational cohort design (retrospective/prospective) was employed. Patients with histologically confirmed high-grade brain tumors treated with radical radiotherapy and temozolomide were included. Clinical response was assessed using MRI-based criteria, while survival outcomes were measured in terms of overall survival (OS) and progression-free survival (PFS). Data were analyzed using descriptive statistics and Kaplan–Meier survival analysis, with subgroup comparisons based on molecular and clinical variables.

Results: The findings demonstrated that combined radiotherapy and temozolomide provided measurable survival benefits, with improved overall and progression-free survival compared to historical radiotherapy-only outcomes. However, complete response was rare, and disease progression remained common within two years. MGMT promoter methylation was significantly associated with improved survival outcomes (p < 0.05). Hematological toxicities, including thrombocytopenia and lymphopenia, were frequently observed and were significantly associated with treatment interruptions.

Conclusion: Radical radiotherapy combined with temozolomide remains the standard and most effective therapeutic approach for high-grade brain tumors, offering meaningful survival benefits. However, prognosis remains poor, highlighting the need for improved molecular stratification, toxicity management, and development of novel therapeutic strategies