నైరూప్య

Current treatment status of adult brain tumors in the Philippine general hospital.

Ranhel C de Roxas, Karlo M Pedro, Jonathan P Rivera, Julette Marie F Batara

Background: Brain tumors, although affecting only a small percentage of the population, poses a large impact worldwide with its high incidence of morbidity and mortality. In the turn of the century, we have witnessed major breakthroughs in the diagnosis and management of patients with brain tumors that is largely becoming molecular-based and personalized. In developing countries like the Philippines, major efforts are yet to be made in order to deliver the ideal treatment modalities to patients with brain tumor, yet certain socio-cultural factors and the lack of standardized protocol limit and even hinder this goal. Hence, it is important to be able to describe our patient population and to determine if they were able to receive adequate treatment in order to pave the way to further identification of ways to clinical improvement in the future. Objectives: This study aims to describe the clinical characteristics of patients diagnosed with brain tumors and to identify the different treatment modalities utilized to treat them in the Philippine General Hospital from January 2010 to December 2015. Methodology: Between 2010 and 2015, a total of 262 medical records of adult patients with brain tumors were successfully retrieved. The demographic data, clinical presentation, performance status, histopathologic diagnosis and treatment of all patients were recorded. The descriptive statistics using the STATA 13.0 software was used to summarize the data obtained. Results: Majority of the patients were females (59.2%) with a mean age of 41.7 years and a mean duration of symptoms of 13.2 months. The majority of the patients (66.8%) had a KPS of 80- 100. Headache, focal deficits, seizures and visual disturbances were the most common symptoms reported. Meningioma, Astrocytoma and glioblastoma were the most common histopathologic diagnosis. More than half of the patients received surgery alone (56.5%) but this is still lower than the expected number of patients who were advised to have surgery (60.7%). The use of combination therapy was found to be increasingly utilized within the duration of the study but a lower proportion of patients completed the planned treatment (13.1%). Around 10.5% of the patients only had regular follow-up to see if any progression in the tumor takes place. No intervention was done in 17.6% of patients who were noted to be either with poor prognosis, those who were lost to follow-up or those who had no consent to any intervention. Conclusion: In summary, there are multiple treatment modalities available to improve the outcome of patients with brain tumors. Although surgery alone remains to be the treatment of choice in majority of the patients, combination therapy was shown to have an increasing popularity. A lower proportion of patients received these treatment modalities than what was expected. Giving minimal or no intervention to the patient was already of decreasing trend in the institution. Further studies to determine the outcome after these treatment modalities on the patients diagnosed with brain tumors are deemed necessary in the future.