Dataset Information

Long-term efficacy of surgical resection with or without adjuvant therapy for treatment of secondary glioblastoma in adults.

ABSTRACT:

Background

There are limited studies on treatment strategies and associated clinical outcomes in patients with secondary glioblastoma (sGBM). We sought to investigate the prognostic factors and treatment decisions in a retrospective cohort of patients with sGBM.

Methods

One hundred and seventy-one patients with sGBM who met the screening criteria were included in this study. Kaplan-Meier survival analysis and Cox survival analysis were used to detect prognostic factors. R (v3.5.0) and SPSS software (v25.0, IBM) were used to perform statistical analyses.

Results

The median overall survival was 303 days (range 23-2237 days) and the median progression-free survival was 229 days (range 33-1964 days) in patients with sGBM. When assessing the relationship between adjuvant treatment outcome and extent of resection (EOR), the results showed that patients underwent gross total resection can benefit from postoperative radiotherapy and chemotherapy, but not in patients underwent subtotal resection. In addition, we also found that aggressive adjuvant therapy can significantly improve clinical outcomes of IDH1-mutated patients but no significant prognostic value for IDH1-wildtyped patients. The univariate Cox regression analyses demonstrated that EOR, adjuvant therapy, and postoperative Karnofsky Performance Scores were prognostic factors for patients with sGBM, and multivariate COX analysis confirmed that adjuvant therapy and EOR were independent prognostic factors.

Conclusions

For patients with sGBM, aggressive postoperative adjuvant therapy after gross total resection was recommended. However, we did not detect a benefit in IDH1-wildtype patients in our cohort.

SUBMITTER: Huang R

PROVIDER: S-EPMC7513886 | biostudies-literature | 2020 Jan-Dec

REPOSITORIES: biostudies-literature

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Publications

Long-term efficacy of surgical resection with or without adjuvant therapy for treatment of secondary glioblastoma in adults.

Huang Ruoyu R Li Guanzhang G Li Yiming Y Wang Yinyan Y Yang Pei P Zhang Chuanbao C Wang Zheng Z Zhou Dabiao D Zhang Wei W Zhang Zhong Z Jiang Tao T

Neuro-oncology advances 20200101 1

<h4>Background</h4>There are limited studies on treatment strategies and associated clinical outcomes in patients with secondary glioblastoma (sGBM). We sought to investigate the prognostic factors and treatment decisions in a retrospective cohort of patients with sGBM.<h4>Methods</h4>One hundred and seventy-one patients with sGBM who met the screening criteria were included in this study. Kaplan-Meier survival analysis and Cox survival analysis were used to detect prognostic factors. R (v3.5.0) ...[more]

PMID: 33005897

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Project description:ObjectiveGlioblastoma multiforme (GBM) is the most common primary malignant central nervous system (CNS) tumor. The Stupp regimen is the standard treatment, although the optimal number of temozolomide (TMZ) treatment cycles remains controversial. We compared the effects of standard 6 cycles versus > 6 cycles of TMZ chemotherapy post-surgery with concurrent chemoradiotherapy on primary GBM patient survival.Patients and methodsWe performed a single center retrospective study of GBM patients that underwent total resection, concurrent chemoradiotherapy, and at least 6 cycles of adjuvant TMZ chemotherapy from June 2011 to August 2018. Patients were divided into 2 groups based on adjuvant TMZ treatment plan: Group A(n = 27): standard 6-cycle adjuvant TMZ therapy and Group B(n = 26): > 6 cycles of adjuvant TMZ therapy. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Continuous variables were analyzed by ANOVA, and the Kaplan-Meier method was used to evaluate PFS and OS. Univariate and multivariate COX analyses determined correlation between survival rates and covariates. We used The Mini Mental State Examination (MMSE) and Karnofsky Performance Status (KPS) to assess patients' neurocognitive function and quality of life.ResultsAfter follow-up, median PFS was 15 months in in Group A (95%CI 9.5-20.5) and 20.1 months in Group B (95%CI 15.9-24.4). Group A median OS was 19.4 months (95%CI 15.5-23.2), compared to 25.6 months in Group B (95%CI 20.4-30.8). The 2-year survival rate of Groups A and B was 36% was 66%, respectively (P = 0.02). and 5-year survival was 7% in both. Multivariate COX regression analysis showed association between patient PFS and long-period adjuvant chemotherapy, but not OS. There were no significant difference in disability or quality of life during treatment with Stupp protocol, but differences in MMSE and KPS were in favour of the Groups B after year 1 of the treatment (P < 0.05).ConclusionsLong-term adjuvant TMZ chemotherapy was beneficial for PFS and 2-year survival rate in GBM patients, and improved their quality of life contemporarily. But OS was not significantly improved.

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Dataset Information

Long-term efficacy of surgical resection with or without adjuvant therapy for treatment of secondary glioblastoma in adults.

Background

Methods

Results

Conclusions

Publications

Long-term efficacy of surgical resection with or without adjuvant therapy for treatment of secondary glioblastoma in adults.

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