Ahmad S. Combined treatment of patients with malignant glial tumors of supratentorial localization

The thesis is dedicated to results of combined treatment improving in patients with malignant brain tumors of supratentorial localization.Optimization of treatment was carried out by increasing of radicalism of surgical interventions and wide introduction of antiblastic chemoradial therapy methods during postoperative period.The research is based on results of analysis of case reports of 382 patients with malignant glial brain tumors of supratentorial localization, have been treated in SI "Institute of Neurosurgery named after acad. A.P. Rodomanov of NAMS of Ukraine" in a period from 2000 to 2011.Clinical-statistic comparison of combined treatment results depending on radicalism of tumor removal in groups of radial (115 supervisions) and chemoradial (267 supervisions) therapy has been carried out and radicalism influence on general and recurrence-free survival rate indices has been estimated. Results of obtained data analysis and systematization gave the opportunity for determining the criteria of selection of patients with malignant glial brain tumors for combined treatment taking into account the principal prognostic factors and their prognostic value, and have showed that the determining factor that has a reliable influence on survival rate indices is the radicalism of surgical intervention.It has been showed that the effectiveness of combined treatment in case of chemoradial therapy using is also connected with tumor's histological subtype and patients' age.The differentiated approach to chemoradial therapy administration in case of malignant glial brain tumors, depending on their histological subtype, has been substantiated with the purpose of most effective chemical medicine determining or the regime of its administration. Treatment pathomorphism in case of radial and chemoradial treatment has been studied and clinical-morphological estimation of the different chemical medicines effectiveness, depending on histological subtype of malignant glial brain tumors, has been carried out. The differentiated approach to chemoradial therapy administration has contributed to effectiveness of highly-malignant gliomas combined treatment improving and, as a final result, to increase of life duration (one-, two-, three-, four- and five-year survival rate amounted to 91.0%, 50.2%, 30.3%. 22.5%, 16.1% accordingly), it's quality and social adaptation of patients with malignant glial brain tumors