Literature DB >> 23460319

Patterns of care and outcome for patients with glioblastoma diagnosed during 2008-2010 in Spain.

Francesc Graus1, Jordi Bruna, Javier Pardo, Domingo Escudero, Dolores Vilas, Inés Barceló, Marta Brell, Carmen Pascual, José A Crespo, Elena Erro, Juan C García-Romero, Jordi Estela, Juan Martino, Almudena García-Castaño, Elena Mata, Manuela Lema, Miguel Gelabert, Rafel Fuentes, Pedro Pérez, Arancha Manzano, Jesús Aguas, Antonio Belenguer, Ana Simón, Iván Henríquez, Mauricio Murcia, Rosa Vivanco, Iñigo Rojas-Marcos, David Muñoz-Carmona, Inmaculada Navas, Pablo de Andrés, Gemma Mas, Miguel Gil, Eugènia Verger.   

Abstract

BACKGROUND: To assess management patterns and outcome in patients with glioblastoma multiforme (GBM) treated during 2008-2010 in Spain.
METHODS: Retrospective analysis of clinical, therapeutic, and survival data collected through filled questionnaires from patients with histologically confirmed GBM diagnosed in 19 Spanish hospitals.
RESULTS: We identified 834 patients (23% aged >70 years). Surgical resection was achieved in 66% of patients, although the extent of surgery was confirmed by postoperative MRI in only 41%. There were major postoperative complications in 14% of patients, and age was the only independent predictor (Odds ratio [OR], 1.03; 95% confidence interval [CI],1.01-1.05; P = .006). After surgery, 57% received radiotherapy (RT) with concomitant and adjuvant temozolomide, 21% received other regimens, and 22% were not further treated. In patients treated with surgical resection, RT, and chemotherapy (n = 396), initiation of RT ≤42 days was associated with longer progression-free survival (hazard ratio [HR], 0.8; 95% CI, 0.64-0.99; P = .042) but not with overall survival (HR, 0.79; 95% CI, 0.62-1.00; P = .055). Only 32% of patients older than 70 years received RT with concomitant and adjuvant temozolomide. The median survival in this group was 10.8 months (95% CI, 6.8-14.9 months), compared with 17.0 months (95% CI, 15.5-18.4 months; P = .034) among younger patients with GBM treated with the same regimen.
CONCLUSIONS: In a community setting, 57% of all patients with GBM and only 32% of older patients received RT with concomitant and adjuvant temozolomide. In patients with surgical resection who were eligible for chemoradiation, initiation of RT ≤42 days was associated with better progression-free survival.

Entities:  

Keywords:  glioblastoma multiforme; older patients; practice patterns; radiotherapy delay; surgical complications

Mesh:

Substances:

Year:  2013        PMID: 23460319      PMCID: PMC3661097          DOI: 10.1093/neuonc/not013

Source DB:  PubMed          Journal:  Neuro Oncol        ISSN: 1522-8517            Impact factor:   12.300


  37 in total

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2.  Super-early initiation of temozolomide prolongs the survival of glioblastoma patients without gross-total resection: a retrospective cohort study.

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10.  Should we continue temozolomide beyond six cycles in the adjuvant treatment of glioblastoma without an evidence of clinical benefit? A cost analysis based on prescribing patterns in Spain.

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