TITLE:
Clinical-Pathological Features and Treatment Modalities of Primary Brain Tumors in Tanzania—4 Years of Institutional Experience
AUTHORS:
Alita Mrema, Salama Iddy, Mamsau Ngoma, Nanzoke Mvungi, Emmanuel Lugina
KEYWORDS:
Primary Brain Tumor, Clinical Profile, Treatment Modalities, Tanzania
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.13 No.5,
May
26,
2022
ABSTRACT: Background: The profile of primary brain tumors and treatment modalities employed in
Tanzania remains largely unknown. The study aimed to describe the baseline
clinical-pathological profile and treatment modalities for primary brain tumors
in adults treated at the Ocean Road Cancer Institute (ORCI) from 2017 to 2020. Materials and Methods: This was a retrospective study conducted at ORCI by reviewing 61 medical
records of patients with primary brain tumors over the age of 15 from January
2017 to December 2020. A structured questionnaire was used to retrieve information
on sociodemographic, clinical-pathological characteristics, and treatment
modalities. The 2007 WHO classification system and the International
Classification of Cancer Diseases (ICD-0-3) were used for classification and
diagnosis. The X2 test and Fisher’s exact test were used to compare
the proportions and an independent t-test was used to compare the means. A
P-value less than 0.05 was deemed statistically significant. The Results:
The mean age of the females was 41.8 years and the mean age of males was 42.9
years. Overall M: F ratio was 1:1.2. Meningioma was the only tumor that was
more commonly found in women with M:F of
1:2.1. The most prevalent symptom was headache (57.4%). Glioblastoma
(GBM) was the most common tumor among adults (38%), followed by astrocytomas
(23%) and meningioma (18%). Approximately 91.8% of all tumors occurred in the
supratentorial region. The Frontal lobe was the most common site (29.5%).
Approximately 81.9% of patients received surgery. The gross tumor resection
(GTR) rate was 26.2%, and the subtotal tumor resection (STR) rate was 55.7%.
Roughly 18% of the tumors were inoperable. An estimated 80.3% of respondents
received radiation therapy. The radiotherapy technique was 3DCRT in two-thirds
of the patients and the rest received conventional 2D radiotherapy. The mean
equivalent dose in the 2 Gy fractions (EQD2) was 43.9 Gy. Respondents with
low-grade intracranial tumors were treated with a mean EQD2 of 47.3 Gy, while
those with high-grade intracranial tumors were treated with a mean EQD2 of 44.3
Gy and the difference was statistically significant. Only half of the patients
who received adjuvant radiotherapy received it concurrently with chemotherapy.
Temozolomide was the most widely used cytotoxic medication. Conclusion: Mean age of the patients was 41 years old. Most tumors were in the
supratentorial area and GBM was the most common tumor. Only meningioma was a
bit more common amongst females. Overall, radiotherapy doses and the gross
tumor resection rates were low. Concurrent chemotherapy with radiotherapy was
given to a few patients.