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Background Glioblastoma is the most common malignant brain tumor in adults. Non-invasive clinical parameters could play a crucial role in treatment planning and serve as predictors of patient survival. Our register-based real-life study aimed to investigate the prognostic value of presenting symptoms. Methods Data on presenting symptoms and survival, as well as known prognostic factors, were retrieved for all glioblastoma patients in Sweden registered in the Swedish Brain Tumor Registry between 2018 and 2021. The prognostic impact of different presenting symptoms was calculated using the Cox proportional hazard model. Results Data from 1458 adults with pathologically verified IDH wild-type glioblastoma were analyzed. Median survival time was 345 days. The 2-year survival rate was 21.5%. Registered presenting symptoms were focal neurological deficits, cognitive dysfunction, headache, epilepsy, signs of raised intracranial pressure, and cranial nerve symptoms, with some patients having multiple symptoms. Patients with initial cognitive dysfunction had significantly shorter survival than patients without; 265 days (245-285) vs. 409 days (365-453; P < .001). The reduced survival remained after Cox regression adjusting for known prognostic factors. Patients presenting with seizures and patients with headaches had significantly longer overall survival compared to patients without these symptoms, but the difference was not retained in multivariate analysis. Patients with cognitive deficits were less likely to have radical surgery and to receive extensive anti-neoplastic nonsurgical treatment. Conclusions This extensive real-life study reveals that initial cognitive impairment acts as an independent negative predictive factor for treatment decisions and adversely affects survival outcomes in glioblastoma patients., Funding Agencies|Swedish Brain Tumour Registry; National Cancer Foundation; Cancer Foundation Northern Sweden; Futurum Academy for Health and Care

The standard treatment of glioblastoma, an aggressive brain tumour, includes radiotherapy combined with temozolomide. Based on a randomised trial, showing five months increased survival, TTF has been introduced in the management of patients with good performance status. Data from the Swedish national quality registry for CNS tumours have been analysed for TTF usage. The results demonstrate that 65 percent of the patients accepted treatment with TTF. More than half of the treated patients interrupted treatment due to low compliance or their own wish. Median treatment time was 164 days, with a range from 0 to 774 days. There was a large variation between different regions in how many patients were offered TTF treatment. A non-significant trend to better survival was seen for the group of TTF-treated patients compared to individually matched controls. In summary, TTF is a new treatment for glioblastoma, with potential to prolong survival also in real world patients. Today, the treatment is not offered equally to all patients, despite national guidelines., Publicerad på Lakartidningen.se 2023-07-03

The standard treatment of glioblastoma, an aggressive brain tumour, includes radiotherapy combined with temozolomide. Based on a randomised trial, showing five months increased survival, TTF has been introduced in the management of patients with good performance status. Data from the Swedish national quality registry for CNS tumours have been analysed for TTF usage. The results demonstrate that 65 percent of the patients accepted treatment with TTF. More than half of the treated patients interrupted treatment due to low compliance or their own wish. Median treatment time was 164 days, with a range from 0 to 774 days. There was a large variation between different regions in how many patients were offered TTF treatment. A non-significant trend to better survival was seen for the group of TTF-treated patients compared to individually matched controls. In summary, TTF is a new treatment for glioblastoma, with potential to prolong survival also in real world patients. Today, the treatment is not offered equally to all patients, despite national guidelines., TTF (tumour treating fields) är en ny, nationellt godkänd utrustning, som inducerar alternerande elektriska fält och används vid behandling av hjärntumören glioblastom. Behandlingen kan vara inskränkande i vardagen, och data från det nationella registret för CNS-tumörer visar att mer än hälften av patienterna avbryter TTF på grund av dålig användningsgrad eller egen önskan. Genomsnittlig behandlingstid enligt registret är 164 dagar. Jämfört med matchade kontroller visar data från registret en trend med längre överlevnad för patienter som behandlas med TTF; dock är skillnaden inte statistiskt signifikant. Det finns en stor regional variation i andelen patienter som erbjudits behandlingen.

Lena Rosenlund,1,2 Eskil Degsell,1,3,4 Asgeir Store Jakola5–71Regional Cancer Centre Stockholm, Stockholm, Sweden; 2Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden; 3Malignant Brain Tumor Pathway, Quality and Patient Safety Department, Karolinska University Hospital, Stockholm, Sweden; 4The Swedish Brain Tumor Association, Stockholm, Sweden; 5Department of Clinical Neurosciences, Institute of Physiology and Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden; 6Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden; 7Department of Neurosurgery, St. Olavs Hospital, Trondheim, NorwayCorrespondence: Lena RosenlundUniversity of Gothenburg, Regional Cancer Centre Stockholm, Box 6909, Stockholm 102 39, SwedenTel +46 73 668 1891Email lena.rosenlund@gu.seBackground: Persons with high-grade glioma face both neurological and cancer-related symptoms from the tumor itself and its treatment affecting their daily lives. Survival alone is not an adequate outcome, the quality of the survivorship experience needs to be regarded with equal importance. Patient-reported outcome (PRO) measures can be used to evaluate treatment effects and symptom management interventions.Purpose: The aim of this review was to identify the use, challenges, and potential of PRO measures in survivors of high-grade glioma.Methods: A narrative expert opinion review was performed on the subject. In addition to our own experiences we searched PubMed, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, and PsycINFO for brain tumor-specific PRO measures used in the population of adult patients with high-grade glioma, both original articles and reviews were included.Results: There are several PRO measures that have been validated for patients with primary brain tumors including high-grade glioma. PRO measures are used both in clinical trials to evaluate the effect of treatment on health-related quality of life, and in d