Real-World Treatment Patterns and Clinicopathologic Predictors of Survival in High-Grade Gliomas: An African Tertiary Center Experience
Adewumi Alabi, Davidson Mbakwe, Chukwuebuka Godspower Eze, Ademola Oyekan, Anthonia SowunmiPURPOSE
Outcomes for high-grade gliomas remain poor in low-resource settings, where treatment completion and dose delivery are often compromised. We evaluated clinicopathologic characteristics, treatment patterns, and survival among patients with brain tumours treated at an African oncology centre.
METHODS
We conducted a retrospective study of 55 patients with brain tumours who received radiotherapy between January 2019 and December 2025. Demographic, histologic, treatment, radiotherapy, and survival data were analysed using Kaplan–Meier methods and Cox regression.
RESULTS
Patients were aged 40–59 years (26/55, 47.3%) or ≥60 years (25/55, 45.5%). Glioblastoma variants accounted for 74.5% (41/55), followed by astrocytoma (4/55, 7.3%), gliosarcoma (2/55, 3.6%), and a single high-grade glioma (1/55, 1.8%). Among patients with surgical records (n = 47), 85.1% (40/47) underwent craniotomy-based resection. Chemotherapy, all temozolomide, was given to 85.5% (47/55), and radiotherapy to 85.5% (47/55). Of those receiving radiotherapy, 78.7% (37/47) completed treatment, while 21.3% (10/47) did not. The commonest regimen was 60 Gy in 30 fractions (35/55, 63.6%). Non-completion was mainly due to death during treatment (8/47, 17.0%), with one case each of toxicity (2.1%) and ongoing treatment at last follow-up (2.1%). Kaplan–Meier analysis showed declining survival, with survival probabilities of 97.1% at 3 months and 8.2% at 24 months; median survival was approximately 10 months. Radiotherapy completion was associated with a non-significant reduction in mortality risk (HR 0.48, 95% CI 0.19 to 1.17;
CONCLUSION
This cohort reflects the burden of glioblastoma and poor survival in routine practice, particularly in LMIC settings. Early mortality limited radiotherapy completion, suggesting aggressive disease biology rather than access alone. Strengthening early diagnosis pathways, timely treatment initiation, clinical monitoring during therapy, and support for treatment completion may help preserve dose intensity and improve outcomes.