Waiting time to radiotherapy as a prognostic factor for glioblastoma patients in a scenario of medical disparities

Arquivos de Neuro-Psiquiatria

Luiz Victor Maia Loureiro¹  Lucíola De Barros Pontes¹  Donato Callegaro-filho¹  Ludmila De Oliveira Koch¹  Eduardo Weltman¹  Elivane Da Silva Victor¹  Adrialdo José Santos¹  Lia Raquel Rodrigues Borges¹  Roberto Araújo Segreto¹  Suzana Maria Fleury Malheiros¹ 

关键词: glioblastoma;    radiotherapy;    waiting time;    delay;    prognosis;    survival;    glioblastoma;    radioterapia;    tempo de espera;    atraso;    prognóstico;    sobrevida;   

DOI  :  10.1590/0004-282X20140202

来源: SciELO

【 摘 要 】

Objective To evaluate the effect of waiting time (WT) to radiotherapy (RT) on overall survival (OS) of glioblastoma (GBM) patients as a reliable prognostic variable in Brazil, a scenario of medical disparities. Method Retrospective study of 115 GBM patients from two different health-care institutions (one public and one private) in Brazil who underwent post-operative RT. Results Median WT to RT was 6 weeks (range, 1.3-17.6). The median OS for WT ≤ 6 weeks was 13.5 months (95%CI , 9.1-17.9) and for WT > 6 weeks was 14.2 months (95%CI, 11.2-17.2) (HR 1.165, 95%CI 0.770-1.762; p = 0.470). In the multivariate analysis, the variables associated with survival were KPS (p < 0.001), extent of resection (p = 0.009) and the adjuvant treatment (p = 0.001). The KPS interacted with WT to RT (HR 0.128, 95%CI 0.034-0.476; p = 0.002), showing that the benefit of KPS on OS depends on the WT to RT. Conclusion No prognostic impact of WT to RT could be detected on the OS. Although there are no data to ensure that delays to RT are tolerable, we may reassure patients that the time-length to initiate treatment does not seem to influence the control of the disease, particularly in face of other prognostic factors.

【 授权许可】

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