Veronica Villani1, Luca Prosperini2, Mario Lecce3, Antonio Tanzilli4, Alessia Farneti5, Dario Benincasa1, Stefano Telera3, Laura Marucci5, Francesca Piludu6, Andrea Pace1. 1. Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 54, 00144, Rome, Italy. 2. Department of Neurosciences, San Camillo-Forlanini Hospital, Rome, Italy. 3. Neurosurgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy. 4. Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 54, 00144, Rome, Italy. antonio.tanzilli@ifo.it. 5. Radiotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy. 6. Neuroradiology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Abstract
BACKGROUND: The majority of patients with glioblastoma (GBM) experience disease progression. At recurrence, treatment options have limited efficacy. Many studies report a limited and short duration response rate. Although clinical trials represent the "gold standard" for providing evidence on efficacy of specific treatment strategies, real-world data can be considered more representative of the "real" GBM population. OBJECTIVE: To describe the management of GBM recurrence in a large real-world sample. METHODS: We analysed retrospectively the data stored in the database of the Neuro-oncology Unit, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy. We considered only data of patients with histological diagnosis of GBM and disease recurrence during their follow-up. We excluded patients who did not receive treatment after the diagnosis. RESULTS: We analysed 422 patients (64% males, 36% females) with a mean age of 59.6 (range 16-87) years. At GBM recurrence, 135 (32.0%) patients underwent palliative care, and 287 (68.0%) underwent other treatments. Patients on palliative care were older, had a worse performance status, and a shorter time between GBM diagnosis and its recurrence. Patients who received chemotherapy in combination with other treatments (surgery and/or radiation therapy) at GBM recurrence had a longer survival than those in palliative care (p < 0.001). Surgery or radiation therapy alone did not have any effect on survival as compared with palliative care (p < 0.001). CONCLUSION: This study confirms the importance of a multidisciplinary approach even at GBM recurrence, suggesting that combination treatments play a key role in management of disease.
BACKGROUND: The majority of patients with glioblastoma (GBM) experience disease progression. At recurrence, treatment options have limited efficacy. Many studies report a limited and short duration response rate. Although clinical trials represent the "gold standard" for providing evidence on efficacy of specific treatment strategies, real-world data can be considered more representative of the "real" GBM population. OBJECTIVE: To describe the management of GBM recurrence in a large real-world sample. METHODS: We analysed retrospectively the data stored in the database of the Neuro-oncology Unit, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy. We considered only data of patients with histological diagnosis of GBM and disease recurrence during their follow-up. We excluded patients who did not receive treatment after the diagnosis. RESULTS: We analysed 422 patients (64% males, 36% females) with a mean age of 59.6 (range 16-87) years. At GBM recurrence, 135 (32.0%) patients underwent palliative care, and 287 (68.0%) underwent other treatments. Patients on palliative care were older, had a worse performance status, and a shorter time between GBM diagnosis and its recurrence. Patients who received chemotherapy in combination with other treatments (surgery and/or radiation therapy) at GBM recurrence had a longer survival than those in palliative care (p < 0.001). Surgery or radiation therapy alone did not have any effect on survival as compared with palliative care (p < 0.001). CONCLUSION: This study confirms the importance of a multidisciplinary approach even at GBM recurrence, suggesting that combination treatments play a key role in management of disease.
Authors: Enrico Franceschi; Marco Bartolotti; Alicia Tosoni; Stefania Bartolini; Carmelo Sturiale; Antonio Fioravanti; Eugenio Pozzati; Renato Galzio; Andrea Talacchi; Lorenzo Volpin; Luca Morandi; Daniela Danieli; Mario Ermani; Alba A Brandes Journal: Anticancer Res Date: 2015-03 Impact factor: 2.480
Authors: Marek Ziobro; Janusz Rolski; Aleksandra Grela-Wojewoda; Aneta Zygulska; Maciej Niemiec Journal: Neurol Neurochir Pol Date: 2008 May-Jun Impact factor: 1.621