4.6 Article

Patterns of care and outcome for patients with glioblastoma diagnosed during 20082010 in Spain

Journal

NEURO-ONCOLOGY
Volume 15, Issue 6, Pages 797-805

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/neuonc/not013

Keywords

glioblastoma multiforme; older patients; practice patterns; radiotherapy delay; surgical complications

Funding

  1. Neuro-Oncology Section of the Spanish Society of Neurology

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To assess management patterns and outcome in patients with glioblastoma multiforme (GBM) treated during 20082010 in Spain. Retrospective analysis of clinical, therapeutic, and survival data collected through filled questionnaires from patients with histologically confirmed GBM diagnosed in 19 Spanish hospitals. We identified 834 patients (23 aged 70 years). Surgical resection was achieved in 66 of patients, although the extent of surgery was confirmed by postoperative MRI in only 41. There were major postoperative complications in 14 of patients, and age was the only independent predictor (Odds ratio [OR], 1.03; 95 confidence interval [CI],1.011.05; P .006). After surgery, 57 received radiotherapy (RT) with concomitant and adjuvant temozolomide, 21 received other regimens, and 22 were not further treated. In patients treated with surgical resection, RT, and chemotherapy (n 396), initiation of RT 42 days was associated with longer progression-free survival (hazard ratio [HR], 0.8; 95 CI, 0.640.99; P .042) but not with overall survival (HR, 0.79; 95 CI, 0.621.00; P .055). Only 32 of patients older than 70 years received RT with concomitant and adjuvant temozolomide. The median survival in this group was 10.8 months (95 CI, 6.814.9 months), compared with 17.0 months (95 CI, 15.518.4 months; P .034) among younger patients with GBM treated with the same regimen. In a community setting, 57 of all patients with GBM and only 32 of older patients received RT with concomitant and adjuvant temozolomide. In patients with surgical resection who were eligible for chemoradiation, initiation of RT 42 days was associated with better progression-free survival.

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