Interdisciplinary treatment of glioblastoma: analysis of prognostic factors and treatment results in unselected patients

• Published in: Neoplasma 2012, Vol.59 (6), p.662-668
• Main Authors: Langsenlehner, T, Groll, M J, Quehenberger, F, Payer, F, Mokry, M, Kapp, K S
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Brain Neoplasms - mortality; Brain Neoplasms - therapy; Combined Modality Therapy; Dacarbazine - analogs & derivatives; Dacarbazine - therapeutic use; Female; Glioblastoma - mortality; Glioblastoma - therapy; Humans; Male; Middle Aged; Proportional Hazards Models; Radiotherapy, Conformal; Survival Rate
• ISSN: 0028-2685
• DOI: 10.4149/neo_2012_084

Aim of the present study was to investigate survival rates of unselected patients with glioblastoma after multimodal treatment and estimation of prognostic factors. Data of 189 patients (118 men; 71 women; median age: 59 years) with histologically confirmed glioblastoma treated from 1999 to 2009 were analyzed retrospectively. Complete tumor resection was performed in 99 patients (52%), subtotal excision in 65 patients (34%), and stereotactic biopsy in 25 patients (13%). In 135 patients (71%), residual tumors were detectable in post-surgical imaging. All patients underwent three-dimensional conformal radiotherapy of the tumor region in shrinking-field technique to a total dose of 60 Gy. Beginning in 2002, 124 patients (66%) received concomitant temozolomide (TMZ) treatment, 76 patients among them were additionally treated with adjuvant TMZ. After disease progression, 74 patients underwent salvage therapy (salvage chemotherapy, n=61; local therapy, n=30). Actuarial 1- and 2- year progression-free survival (PFS) rates were 32% and 7%, overall survival (OS) rates were 54% and 22%, respectively. Without TMZ, 1- and 2- year OS rates were 47% and 11%, with concomitant TMZ 57% and 28%, and with concomitant and adjuvant TMZ 72% and 44%. In multivariate Cox proportional hazards regression models, age (p