Hypofractionated Radiotherapy Versus Conventional Radiotherapy in Management of Patients with High Grade Gliomas Older Patients and Poor Performance State

Background: as guidelines for glioblastoma treatment was based on trial included patients less 70 years old and good performance only. We did a randomised trial to assess the optimum palliative treatment in patients aged 60 years and older and poor performance patients. Patients and Methods: this study included 50 (elderly and/or frail patients) with high grade glioma who presented to the Clinical Oncology Department, Ain Shams University during the period of November 2013 to march 2016.Theywere categorized in two groups (25 in each group). Group A received standard conventional fractionation of 60 Gy in 30 fractions over 6 weeks.  Group B received 45 Gy in 15 fractions over 3 weeks. Results: progression free survival in conventional RTH group was 4.1 months, while in hypo fractionated group it was 4.2 with no statistically significant difference between the two groups. The median overall survival was 7.2 in the conventional group and 7.4 months in the hypo fractionated group with no statistically significant difference between the two groups. After age analysis patients≥ 70 years old median overall survival was 5.4 month and 6.8 month in patients ≥ 70 years received hypofractionation.it was statistically significant difference (P value = 0.047). Conclusion: this study showed that short course of radiotherapy has the same efficacy as slandered conventional radiotherapy in older patients and frail patients. And in patients over 70 years short course should be the slandered of care.