Radiation treatment with twice a day fractionation versus conventional fractionation in high grade astrocytoma. A retrospective study.

A consecutive series of 73 patients with high grade astrocytoma treated by surgery and postoperative radiotherapy was analysed. A total tumour dose of 60 Gy was delivered with either 2 Gy daily fractions (24 patients) or twice a day 1.5 Gy fractions, with a 4-hour-interval (49 patients). The analysis of survival with respect to patient variables showed that age and performance status were significant prognostic factors. As the type of fractionation was not randomly assigned, the comparison between the conventional schedule (CF) and the multifractionated schedule (MFD) was performed by means of a multivariate analysis adjusting for basic prognostic factors; CF proved to be significantly superior to MFD. The possible reasons for the disagreement between our results and the theoretical expectations in favour of MFD are discussed.