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Aim: To assess clinicopathological features and outcomes in patients of primary gliosarcoma with changing trends of treatment. Materials and 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). Conclusion: 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.

AIM: To assess the clinicopathological features and outcome in patients of primary gliosarcoma with changing trends of treatment. MATERIALS AND METHODS: Medical records were reviewed over a 5yearsperiod from 2009 to2013 of Gliosarcoma treated in the department. All patients who received 3D-Conformal Radiotherapy (3DCRT) with or without concurrent and adjuvant Temozolomide post surgery were included in the analysis. RESULTS: A total 27 patients were included in this study. Median age of presentation was 54 years (rang9-69 years), male to female ratio was 1.25:1, median KPS at presentation was 70. At presentation all patients had raised intracranial tension with motor symptoms in 48.1%, Memory impairment in 6 patients, Seizures and dimness of vision was seen in 18.5% and 11.1% cases respectively. Most common location of the tumour was temporal lobe (48.1%).About 60% (n = 16) patients underwent Gross total resection. On histopathological examination all patients showed biphasic pattern with glial fibrillary acidic protein positivity for (GFAP) glial component and vimentin positivity for mesenchymal component. Twenty three (80.8%) patients received radical radiotherapy i.e. 60 Gy/30#/6 weeks and 4 patients received hypo-fractionated radiotherapy 40 Gy in 15 fractions in 3 weeks. Eleven (42.3%) patients received Concurrent and adjuvant Temozolomide. Median overall survival of our patients was 9 months. Six months survival in the chemo-radiation arm was 82% as compared to 58% seen in patients who were treated with radiotherapy alone. CONCLUSION: Treating Gliosarcoma is a major therapeutic challenge to a clinician because of its poor prognosis, aggressive clinical behavior, rarity and limited clinical experience. Addition of Temozolomide has shown a better trend in survival though it is statistically not significant