Clinical trial participation and outcome for patients with glioblastoma: Multivariate analysis from a comprehensive dataset

被引:46
作者
Field, Kathryn M. [1 ,2 ,3 ]
Drummond, Katharine J. [4 ,5 ]
Yilmaz, Merve [6 ]
Tacey, Mark [7 ]
Compston, Daniel [3 ]
Gibbs, Peter [1 ,2 ,3 ,8 ]
Rosenthal, Mark A. [1 ,8 ]
机构
[1] Royal Melbourne Hosp, Dept Med Oncol, Melbourne, Vic, Australia
[2] Ludwig Inst Canc Res, Parkville Branch, Parkville, Vic, Australia
[3] Royal Melbourne Hosp, BioGrid Australia, Parkville, Vic 3050, Australia
[4] Royal Melbourne Hosp, Dept Neurosurg, Melbourne, Vic, Australia
[5] Univ Melbourne, Dept Surg, Melbourne, Vic 3010, Australia
[6] Univ Melbourne, Melbourne Med Sch, Melbourne, Vic 3010, Australia
[7] Royal Melbourne Hosp, Melbourne EpiCtr, Melbourne, Vic, Australia
[8] Univ Melbourne, Dept Med, Melbourne, Vic 3010, Australia
关键词
Clinical trial; Glioblastoma; Outcomes research; Prognosis; Survival; SOCIOECONOMIC-STATUS; ADJUVANT TEMOZOLOMIDE; PROGNOSTIC-FACTORS; CANCER SURVIVAL; TERM; RADIOTHERAPY; CONCOMITANT; MINORITIES; MANAGEMENT; MORTALITY;
D O I
10.1016/j.jocn.2012.09.013
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Glioblastoma multiforme (GBM) is the most common malignant brain tumor in adults. Although multiple clinical and tumor-related variables affect survival outcomes, the effect of clinical trial participation has not been explored. The aim of this study was to determine whether clinical trial participation improves outcome for patients with GBM. Data from patients with GBM were accessed from a dataset collected over 12 years (1998-2010) at two institutions. Univariable and multivariate logistic regression analyses were performed to look for relationships between clinical trial participation, other baseline clinical and sociodemographic variables and overall survival (OS). In total, 542 patients were identified and included in the analysis; median age was 62 years. Sixty-one patients (11%) were enrolled in a clinical trial. Clinical trial enrollment was associated with improved median survival (14.5 months compared to 6.3 months, p < 0.001) and this difference remained significant in multivariate analysis (hazard ratio 0.67, p = 0.046). Age, poor performance status and operation type were also independent predictors for OS in multivariate analysis. Disease site, socioeconomic status and co-morbidity did not affect survival outcome. This is the first study in patients with GBM to suggest a survival benefit from clinical trial participation, independent of age and performance status; while also confirming the importance of other previously reported prognostic factors. This should encourage clinicians to offer trial therapies to patients with GBM and encourage patients to participate in available studies. (c) 2012 Elsevier Ltd. All rights reserved.
引用
收藏
页码:783 / 789
页数:7
相关论文
共 28 条
[21]   Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial [J].
Stupp, Roger ;
Hegi, Monika E. ;
Mason, Warren P. ;
van den Bent, Martin J. ;
Taphoorn, Martin J. B. ;
Janzer, Robert C. ;
Ludwin, Samuel K. ;
Allgeier, Anouk ;
Fisher, Barbara ;
Belanger, Karl ;
Hau, Peter ;
Brandes, Alba A. ;
Gijtenbeek, Johanna ;
Marosi, Christine ;
Vecht, Charles J. ;
Mokhtari, Karima ;
Wesseling, Pieter ;
Villa, Salvador ;
Eisenhauer, Elizabeth ;
Gorlia, Thierry ;
Weller, Michael ;
Lacombe, Denis ;
Cairncross, J. Gregory ;
Mirimanoff, Rene-Olivier .
LANCET ONCOLOGY, 2009, 10 (05) :459-466
[22]   RECRUITING MINORITIES INTO CLINICAL-TRIALS - TOWARD A PARTICIPANT-FRIENDLY SYSTEM [J].
SWANSON, GM ;
WARD, AJ .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1995, 87 (23) :1747-1759
[23]  
Tramacere F, 2008, CLIN TER, V159, P233
[24]   Effects of socioeconomic and geographic variations on survival for adult glioma in England and Wales [J].
Tseng, Jen-Ho ;
Merchant, Edwin ;
Tseng, Ming-Yuan .
SURGICAL NEUROLOGY, 2006, 66 (03) :258-263
[25]   Systematic review to determine whether participation in a trial influences outcome [J].
Vist, GE ;
Hagen, KB ;
Devereaux, PJ ;
Bryant, D ;
Kristofersen, DT ;
Oxman, AD .
BMJ-BRITISH MEDICAL JOURNAL, 2005, 330 (7501) :1175-1179
[26]   Origins of socio-economic inequalities in cancer survival: a review [J].
Woods, LM ;
Rachet, B ;
Coleman, MP .
ANNALS OF ONCOLOGY, 2006, 17 (01) :5-19
[27]   Assessing the impact of socio-economic status on cancer survival in New South Wales, Australia 1996-2001 [J].
Yu, Xue Qin ;
O'Connell, Dianne L. ;
Gibberd, Robert W. ;
Armstrong, Bruce K. .
CANCER CAUSES & CONTROL, 2008, 19 (10) :1383-1390
[28]  
2010, REP 2009 CLIN TRIAL