title: Impact of changing trends of treatment on outcome of cerebral gliosarcoma: A tertiary care centre experience.
abstract: OBJECTIVE
  To assess clinicopathological features and outcomes in patients of primary gliosarcoma with changing trends of treatment.
  
  
  METHODS
  Medical records were reviewed and data collected on primary gliosarcoma over a 5-year period (2009-2013) from the departmental case files.
  
  
  RESULTS
  A total 27 patients were included in this study. The median age of presentation was 54 years. There was a slight male preponderance, with male to female ratio of 1.25:1. The most common location of the tumor was temporal lobe (44.4%). Gross total resection was possible in 19 cases, near total excision was done in five cases, and only partial excision with decompression in three cases. Of the 27 patients, 80.8% patients received post-operative radical external beam radiotherapy of 60 Gy/30#/6 weeks. Concurrent and adjuvant temozolomide was used in 42.3% cases, depending on affordability and tolerance. Median overall survival was 9 months. On subgroup analysis, median overall survival in the radiotherapy plus temozolomide group was 10 months as compared to 9 months in the radiotherapy alone group; however, this was not statistically significant.(P = 0.244).
  
  
  CONCLUSIONS
  Treating Gliosarcoma is a major therapeutic challenge for a clinician because of its poor prognosis, aggressive clinical behavior, rarity, and limited clinical experience. With surgery and concurrent chemoradiation, we were able to achieve a median overall survival of 9 months. Addition of temozolomide has shown a better trend in survival though it is not statistically significant.
authors.affiliation: Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Narendra
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Tapesh
authors.initials: T
authors.lastname: Bhattacharyya
authors.affiliation: Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Karan
authors.initials: K
authors.lastname: Chanchalani
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Shalunke
authors.affiliation: Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: B D
authors.initials: BD
authors.lastname: Radotra
authors.affiliation: Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Budhi Singh
authors.initials: BS
authors.lastname: Yadav
keywords: Gliosarcoma; radiotherapy; temozolomide
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