Radiotherapy for malignant glioma

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Abstract
Well conducted clinical trials provide convincing evidence that patients' age, histology (anaplastic astrocytoma or glioblastoma multiforme), and degree of functional impairment wrongly influence the duration of survival.2 They offer a rational basis for selecting treatment for individual patients. Disabled patients with glioblastoma multiforme aged 60 years or over will derive limited benefit from aggressive treatment.3 Conversely a 35 year old patient with post-resection histology of anaplastic astrocytoma and minimal neurological deficit has a high probability of remaining well for 18 months or longer if treated with the optimal schedule of high dose radiotherapy. In both of these scenarios it is important to ensure that the toxicity of treatment does not outweigh the survival benefit.