Evaluation of outcome and prognostic factors in patients of glioblastoma multiforme: A single institution experience

Journal of Neurosciences in Rural Practice

卷:04

Kanchan Kumar Mukherjee¹  Narendra Kumar²  Rupali Aggarwal²  Pankaj Kumar²  Shabab Lalit Angurana²  Anjan Bera²  Suresh Chander Sharma²  Ritesh Kumar²  Divya Khosla² 

[1] Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Sector - 12, Chandigarh, India;

[2] Department of Radiotherapy and Oncology,India;

关键词: glioblastoma multiforme;    prognostic factors;    radiotherapy;    survival;    temozolomide;   

DOI  :  10.4103/0976-3147.116455

来源: DOAJ

【 摘 要 】

Aims: We present retrospective analysis of patients of glioblastoma multiforme (GBM) and discuss clinical characteristics, various treatment protocols, survival outcomes, and prognostic factors influencing survival. Materials and Methods: From January 2002 to June 2009, 439 patients of GBM were registered in our department. The median age of patients was 50 years, 66.1% were males, and 75% underwent complete or near-total excision. We evaluated those 360 patients who received radiotherapy (RT). Radiotherapy schedule was selected depending upon pre-RT Karnofsky Performance Status (KPS). Patients with KPS < 70 (Group I, n = 48) were planned for RT dose of 30-35 Gy in 10-15 fractions, and patients with KPS ≥ 70 (Group II, n = 312) were planned for 60 Gy in 30 fractions. In group I, six patients and in group II, 89 patients received some form of chemotherapy (lomustine or temozolomide). Statistical Analysis Used: Statistical analysis was done using Statistical Package for Social Sciences, version 12.0. Overall survival (OS) was calculated using Kaplan-Meier method, and prognostic factors were determined by log rank test. The Cox proportional hazards model was used for multivariate analysis. Results: The median follow-up was 7.53 months. The median and 2-year survival rates were 6.33 months and 2.24% for group I and 7.97 months and 8.21% for group II patients, respectively ( P = 0.001). In multivariate analysis, site of tumor (central vs. others; P = 0.006), location of tumor (parietal lobe vs. others; P = 0.003), RT dose (<60 Gy vs. 60 Gy; P = 0.0001), and use of some form of chemotherapy ( P = 0.0001) were independent prognostic factors for survival. Conclusions: In patients with GBM, OS and prognosis remains dismal. Whenever possible, we should use concurrent and/or adjuvant chemotherapy to maximize the benefits of post-operative radiotherapy. Patients with poor performance status may be considered for hypofractionated RT schedules, which have similar median survival rates as conventional RT.

【 授权许可】

Unknown