[Radiotherapeutic aspects of the treatment of malignant gliomas]

In addition to surgery, curative radiotherapy is the most important mode of treatment for malignant gliomas. Radiotherapy makes it possible to significantly prolong the mean survival time. Since the majority of higher-grade gliomas recur in the area subjected to surgery or radiotherapy, radio-oncologists put the greatest possible emphasis on local tumour control. Increasing the dosage above 60 Gy raises the incidence of complications and in random studies has not been shown to bring definite therapeutic advantages. It appears important to reduce the size of the field while increasing the dose, especially when using stereotactic irradiation methods and intraoperative radiotherapy. The change in fractionating rhythm and the implementation of radiosensitizers have brought encouraging results in clinical trials, but their definitive therapeutic value remains to be proven by further research. Applied irradiation with high LET, as well as the use of radio-protectors and hyperthermic methods are still in the experimental stage.