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

被引:77
作者
Graus, Francesc [1 ]
Bruna, Jordi [3 ]
Pardo, Javier [4 ]
Escudero, Domingo [5 ]
Vilas, Dolores [5 ]
Barcelo, Ines [6 ]
Brell, Marta [7 ]
Pascual, Carmen [8 ]
Crespo, Jose A. [8 ]
Erro, Elena [9 ]
Garcia-Romero, Juan C. [10 ]
Estela, Jordi [11 ]
Martino, Juan [12 ]
Garcia-Castano, Almudena [13 ]
Mata, Elena [13 ]
Lema, Manuela [14 ]
Gelabert, Miguel [15 ]
Fuentes, Rafel [16 ]
Perez, Pedro [17 ]
Manzano, Arancha [17 ]
Aguas, Jesus [18 ]
Belenguer, Antonio [19 ]
Simon, Ana [19 ]
Henriquez, Ivan [20 ]
Murcia, Mauricio [20 ]
Vivanco, Rosa [21 ]
Rojas-Marcos, Inigo [22 ]
Munoz-Carmona, David [23 ]
Navas, Inmaculada [24 ]
de Andres, Pablo [25 ]
Mas, Gemma [26 ]
Gil, Miguel [27 ]
Verger, Eugenia [2 ]
机构
[1] Hosp Clin Barcelona, Serv Neurol, E-08036 Barcelona, Spain
[2] Hosp Clin Barcelona, E-08036 Barcelona, Spain
[3] Hosp Univ Bellvitge, Serv Neurol, Lhospitalet De Llobregat, Spain
[4] Hosp Quiron, Serv Neurol, Madrid, Spain
[5] Hosp Badalona Germans Trias & Pujol, Serv Neurol, Badalona, Spain
[6] Hosp Son Espases, Serv Neurol, Mallorca, Spain
[7] Hosp Son Espases, Mallorca, Spain
[8] Hosp Univ Miguel Servet, Serv Neurol, Zaragoza, Spain
[9] Complejo Hosp Navarra, Serv Neurol, Pamplona, Spain
[10] Complejo Hosp Navarra, Pamplona, Spain
[11] Hosp Parc Tauli, Serv Neurol, Sabadell, Spain
[12] Hosp Univ Marques Valdecilla, Serv Neurosurg, Santander, Spain
[13] Hosp Univ Marques Valdecilla, Santander, Spain
[14] Complejo Hosp Univ Santiago, Serv Neurol, Santiago De Compostela, Spain
[15] Complejo Hosp Univ Santiago, Santiago De Compostela, Spain
[16] Hosp Univ Josep Trueta, Serv Radiotherapy, Girona, Spain
[17] Hosp Clin San Carlos, Med Oncol Serv, Madrid, Spain
[18] Hosp Clin Univ Lozano Blesa, Serv Neurosurg, Zaragoza, Spain
[19] Hosp Gen Castello, Serv Neurol, Castellon de La Plana, Spain
[20] Hosp Univ St Joan, Serv Radiotherapy, Reus, Spain
[21] Hosp del Mar, Serv Neurol, Barcelona, Spain
[22] Hosp Gen Juan Ramon Jimenez, Serv Neurol, Huelva, Spain
[23] Hosp Gen Juan Ramon Jimenez, Huelva, Spain
[24] Fdn Jimenez Diaz, Serv Neurol, E-28040 Madrid, Spain
[25] Fdn Jimenez Diaz, E-28040 Madrid, Spain
[26] Hosp Francesc Borja, Serv Neurol, Gandia, Spain
[27] Inst Catala Oncol, Med Oncol Serv, Lhospitalet De Llobregat, Spain
关键词
glioblastoma multiforme; older patients; practice patterns; radiotherapy delay; surgical complications; RADIOTHERAPY PLUS CONCOMITANT; ELDERLY-PATIENTS; ADJUVANT TEMOZOLOMIDE; PERIOPERATIVE COMPLICATIONS; PHASE-3; TRIAL; SURVIVAL; MULTIFORME; POPULATION; RESECTION; GLIOMA;
D O I
10.1093/neuonc/not013
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:797 / 805
页数:9
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