[Randomized controlled study of limited margins IMRT and temozolomide chemotherapy in patients with malignant glioma]

To evaluate the efficacy of limited margins intensity-modulated radiotherapy (IMRT) with temozolomide chemotherapy in patients with malignant glioma, and explore the prognostic factors of malignant glioma.

A total of 33 whole-resected patients, 14 partial-resected patients and 3 biopsied patients were randomly divided into limited margins group and routine margins group. The patients were treated with IMRT and temozolomide concurrent chemotherapy, subsequently adjuvant chemotherapy. Then all the patients were evaluated 2 months later after concurrent chemoradiotherapy. Progression-free survival in 1 year (PFS-1), progress free survival rate in 1 year (PFSR-1) and 1 year survival rate (SR-1) were recorded.All the possible prognostic factors were analyzed.

Routine margins group: complete response (CR) 19, partial response (PR) 2, stable disease (SD) 2, progressive disease (PD) 2; Limited margins group: CR 16, PR 6, SD 1, PD 2. Mean PFS-1 of the two groups were 11.64 and 11.36 months, respectively. PFSR-1 were 84% in routine margins group and 80% in limited margins group. SR-1 of two groups were both 100%. Surgery results and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status were correlated with immediate-term prognosis by either univariate or multivariate analysis. Both surgery results and immediate-term prognosis were relevant factors to PFS-1. Progression sites in two groups had no statistical difference by analysis.

Both groups gained favorable results, and limited margins doesn't increase local failures. Surgery results are important prognostic factors to immediate-term prognosis and PFS-1.