HYPOFRACTIONATION IN THE COMPLEX TREATMENT OF PATIENTS WITH GLIOBLASTOMAS

Skorina Margarita Olegovna, Chernykh Marina Vasilyevna, Romanov Denis Sergeevich, Ivanov Valery Anatolyevich

Glioblastoma is the most common and aggressive type of primary malignant formation in the brain, accounting for up to 50% of all cases of gliomas. These tumors have a variety of genetic and epigenetic characteristics, which creates barriers to effective treatment. The modern classification of this pathology, based on molecular profiling, reflects a deeper understanding of its pathogenesis and offers new approaches to therapy. The study of this type of tumor revealed promising immunotherapeutic methods, including checkpoint inhibitors, vaccines, CAR-T cell therapy and viral therapy, although their effectiveness is still questionable. Despite advances in the development of treatment methods, including surgical interventions, radiation and pharmacological therapy, the median survival rate varies from 14.6 to 20.5 months. In this situation, the search for new therapeutic and diagnostic approaches based on In this situation, the search for new therapeutic and diagnostic approaches aimed at reducing the treatment time without loss of effectiveness or increase in toxicity becomes particularly relevant. The standard method of treatment is surgery, after which a course of chemo and radiotherapy is performed (classical fractionation with a total dose of 60 Gray and a single dose of 2 Gray in combination with the use of temozolomide). This is 30 fractions carried out on working days, which is almost 10% of the remaining life time of the patient. Recent studies focus on the possibility of shortening the exposure period for elderly patients and those with concomitant diseases, while maintaining efficacy and acceptable levels of toxicity. Hypofraction radiotherapy involves a decrease in the number of fractions with an increase in a single dose. Combination therapy, including hypofractive radiotherapy and temozolomide, can improve the prognosis of survival in certain groups of patients with glioblastoma.

Keywords:glioblastoma, radiation therapy, overall survival, hypofractionation.