Li-Tsun Shieh1, How-Ran Guo2, Yu-Kang Chang3, Na-Mi Lu4, Sheng-Yow Ho5. 1. Department of Radiation Oncology, Chi-Mei Medical Center, Liouying, Tainan, Taiwan. 2. Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. 3. Department of Diagnostic Radiology, Chi-Mei Medical Center, Liouying, Tainan, Taiwan. 4. Department of Pathology, Chi-Mei Medical Center, Liouying, Tainan, Taiwan. 5. Department of Radiation Oncology, Chi-Mei Medical Center, Liouying, Tainan, Taiwan; Graduate Institute of Medical Science, Chang Jung Christian University, Tainan, Taiwan. Electronic address: shengho@seed.net.tw.
Abstract
PURPOSE: Glioblastoma (GBM) has the highest fatality rate among primary malignant brain tumors. GBMs with synchronous multiple foci (multiple GBMs) is rarely diagnosed in the clinical scenario. This study aims to compare the clinical characteristics between multiple and single GBMs and to identify factors associated with the survival of GBM and evaluate their effects. METHODS: We retrospectively reviewed the medical records of patients with primary GBM in a referral medical center in Taiwan who were diagnosed between 2005 and 2016. They were identified from the cancer registry database of the center and followed from the date of diagnosis to october 2018. The primary endpoint of this study was overall survival (OS), and the independent factors for survival were identified through Cox regressions. RESULTS: A total of 48 patients were identified, of whom 44 GBM (92%) and 4 gliosarcoma (GSM) (8%). Preoperative images showed five (10%) patients had multiple brain lesions. GSM showed a high ratio of multiple lesions (50%) than patients with GBM (5%) (p = 0.05). Those with multiple lesions had significantly worse median OS of 8.2 months compared to patients with a single lesion (16 months, p = 0.03). We found that multiple GBMs was a predictor of worse survival (hazard ratio [HR] = 3.57, 95% confidence interval [95%CI]: 1.26-10.13) after adjusting for other significant predictor of radiotherapy (HR = 0.47, 95%CI: 0.23-0.96). CONCLUSION: Patients with multiple GBMs had worse survival compared to those with single GBM. GBM patients without post-operative radiotherapy were also a predictor of worse survival.
PURPOSE:Glioblastoma (GBM) has the highest fatality rate among primary malignant brain tumors. GBMs with synchronous multiple foci (multiple GBMs) is rarely diagnosed in the clinical scenario. This study aims to compare the clinical characteristics between multiple and single GBMs and to identify factors associated with the survival of GBM and evaluate their effects. METHODS: We retrospectively reviewed the medical records of patients with primary GBM in a referral medical center in Taiwan who were diagnosed between 2005 and 2016. They were identified from the cancer registry database of the center and followed from the date of diagnosis to october 2018. The primary endpoint of this study was overall survival (OS), and the independent factors for survival were identified through Cox regressions. RESULTS: A total of 48 patients were identified, of whom 44 GBM (92%) and 4 gliosarcoma (GSM) (8%). Preoperative images showed five (10%) patients had multiple brain lesions. GSM showed a high ratio of multiple lesions (50%) than patients with GBM (5%) (p = 0.05). Those with multiple lesions had significantly worse median OS of 8.2 months compared to patients with a single lesion (16 months, p = 0.03). We found that multiple GBMs was a predictor of worse survival (hazard ratio [HR] = 3.57, 95% confidence interval [95%CI]: 1.26-10.13) after adjusting for other significant predictor of radiotherapy (HR = 0.47, 95%CI: 0.23-0.96). CONCLUSION:Patients with multiple GBMs had worse survival compared to those with single GBM. GBM patients without post-operative radiotherapy were also a predictor of worse survival.
Authors: Kaumudi Bhawe; Jayanta K Das; Changwon Yoo; Quentin Felty; Zhenghua Gong; Alok Deoraj; Juan P Liuzzi; Nasreen Z Ehtesham; Seyed E Hasnain; Varindera Paul Singh; Ishani Mohapatra; Ricardo Jorge Komotar; Deodutta Roy Journal: J Cancer Res Clin Oncol Date: 2022-04-20 Impact factor: 4.553
Authors: Ryan T Woodall; David A Hormuth Ii; Chengyue Wu; Michael R A Abdelmalik; William T Phillips; Ande Bao; Thomas J R Hughes; Andrew J Brenner; Thomas E Yankeelov Journal: Biomed Phys Eng Express Date: 2021-05-28