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Impact of treatment on survival of patients with secondary glioblastoma.
- Source :
-
Journal of neuro-oncology [J Neurooncol] 2017 Jun; Vol. 133 (2), pp. 309-313. Date of Electronic Publication: 2017 May 30. - Publication Year :
- 2017
-
Abstract
- Data concerning treatment of secondary glioblastoma evolving from previously treated WHO II or III grade tumors are very scarce. The aim of this study was to evaluate the impact of surgical resection and adjuvant treatment on survival in patients with secondary glioblastoma. Thirty-nine patients with secondary glioblastoma evolving from previously treated lower grade gliomas between 2004 and 2015 were included. We evaluated the extent of resection, pathological parameters, adjuvant treatment, as well as survival after malignant transformation. The primary tumor grade was WHO II in 16 (41.0%) and WHO III in 23 (59.0%) patients. Median age was 43 years (range 23-67). Median KPS was 80 (range 60-100) before surgery, and 70 (range 50-100) after surgery. Gross total resection (GTR) of contrast-enhancing disease was achieved in 19 (48.7%) patients. Adjuvant treatment was radio-chemotherapy in 23 (59.0%), radiotherapy in three (7.7%), chemotherapy in five (12.8%) and none in eight (20.5%) patients. Median survival was 11 months (range 1-35) in the entire group. Time since initial diagnosis and previous treatment did not correlate with survival after glioblastoma. Failed GTR, poor KPS after surgery, and no adjuvant treatment were prognostic factors for shorter survival in univariate analysis (p < 0.0001, p = 0.028 and p = 0.003). In selected patients, complete resection and adjuvant treatment may prolong survival in spite of multiple previous therapies.
- Subjects :
- Adult
Aged
Chi-Square Distribution
Female
Humans
Kaplan-Meier Estimate
Karnofsky Performance Status
Male
Middle Aged
Retrospective Studies
Young Adult
Antineoplastic Agents therapeutic use
Brain Neoplasms drug therapy
Brain Neoplasms mortality
Brain Neoplasms surgery
Glioblastoma drug therapy
Glioblastoma mortality
Glioblastoma surgery
Neurosurgical Procedures methods
Treatment Outcome
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7373
- Volume :
- 133
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of neuro-oncology
- Publication Type :
- Academic Journal
- Accession number :
- 28560660
- Full Text :
- https://doi.org/10.1007/s11060-017-2415-y