P17.20 PATTERNS OF CARE AND OUTCOME FOR PATIENTS WITH RECURRENT GLIOBLASTOMA

• Published in: Neuro-oncology (Charlottesville, Va.) Va.), 2014-09, Vol.16 (suppl 2), p.ii91-ii91
• Main Authors: De Cock, L., Sala, Q., Barrie, M., Boucard, C., Metellus, P., Tabouret, E., Padovani, L., Figarella-Branger, D., Dufour, H., Chinot, O.
• Format: Article
• Language: English
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/nou174.350

BACKGROUND: Access to salvage treatment for patients with recurrent GB is poorly documented in daily practice. Our objective was to assess patterns of care and outcome in patients with recurrent GB. METHODS: A retrospective analysis of consecutive patients with histologically proven GB treated in 2008 and 2011 at Timone University Hospital was performed. Clinical, therapeutic and outcome data were collected. RESULTS: 207 patients were identified (2008: n = 99; 2011: n = 108). Patient's characteristics, pattern of care and outcome were similar between 2008 and 2011 and, therefore analyzed together. Overall survival from initial diagnosis (OSI) was 15.0 months (95% CI 12.9-17.1). Recurrence was diagnosed in 158 pts (76.3%). Overall survival from recurrence (OSR) was 6.6 months (95% CI 5.6-7.5). 117/158 pts (74%) of them received salvage treatment; 41 (26%) received no trt. 53, 48, and 16 pts received 1, 2 and > 2 lines at recurrence respectively. 2line treatment consist of chemotherapy (CT), n = 23 (19.7%), bevacizumab (BEV) +/- CT, n = 63 (53.8%), surgery +/- carmustine wafer (CW), n = 16 (10.1%), reirradiation (RRT) (1) and inclusion in clinical trials, n = 16 (9.5%). OSR in patient treated with CT + /-BEV was 8.0 months (95% CI 6.9-9.1) and OSI was 18.9 months (95% CI 16.3-21.5). OSR in patients with local treatment (surgery +/-CW, RRT) was 10.8 months (95% CI 7.7-13.8); OSI was 29.7 months (CI 95% 10.5-39). In pts who received no salvage trt, OSR and OSI were 1.8 (95% CI 1.4-2.1) and 7.5 (95% CI 6.4-8.6) months respectively. In patients aged over 70 years (n = 76), recurrence was determined in 50 of whom 30 (60%) received a salvage treatment. OSR was 5.2 months (95% CI 3.9-6.6) and OSI was 8.9 months (95% CI 7.5-10.4). In pts aged less than or equal to 70 years (n = 131), recurrence was determined in 108 of whom 87 (81%) received a treatment at progression. OSR was 7.1 months (95% CI 5.9-8.4) and OSI was 18.1 months (95% CI 15.2-21.0). CONCLUSION: In a center assuming mainly primary care of patients, 75% of the pts identified with recurrent GB received salvage treatment. Differences in outcome associated to systemic treatment, second surgery, and no treatment could be related to pts/tumor heterogeneity and treatment. Access to and results of salvage treatment in elderly are limited.