Document Detail


Survival improvement in patients with glioblastoma multiforme during the last 20 years in a single tertiary-care center.
MedLine Citation:
PMID:  12879737     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
METHODOLOGY: The survival of 357 consecutive patients with newly diagnosed glioblastoma multiforme (GBM) in three treatment groups reflecting different time-periods of diagnosis (A: 1982-1984; B: 1994/1995; C: 1996-1998) was analysed to assess the impact and the potential improvement of changing treatment strategies in our tertiary-care center. PATIENTS AND METHODS: Group A (n = 100) included all consecutive patients diagnosed from 1982 to 1984 and served as the historical control. Group B (n = 93) included all consecutive patients diagnosed in 1994/1995 and group C (n = 164) those diagnosed from 1996 to 1998. Survival in the three treatment groups (A vs. B vs. C) was analysed according to treatment given after neurosurgical intervention (i.e. no specific therapy versus radiotherapy versus combined radio-/chemotherapy), and according to first-line chemotherapy, age (< 40, 40-60, > 60), sex, and tumor location (hemispheric versus bilateral or multifocal tumors, and tumors involving eloquent brain areas). Survival was analysed using Kaplan-Meier's non-parametric method. A p-value < 0.05 was considered statistically significant. RESULTS: Patients in groups A and B received radio- and/or chemotherapy to a varying extent (radiotherapy: group A: 22%, group B: 62%; chemotherapy: group A: 6%, group B: 33%). Chemotherapy was administered after termination of radiotherapy in both groups. In group C, 96% of patients received combined radio-/chemotherapy which was administered concomitantly and started within three weeks after surgery. Median survival was 5.2 months in group A, 5.1 months in group B and 14.5 months in C (p < 0.0001). Nine patients in group A (9%), 9 in group B (10%) and 40 in group C (25%) survived more than 18 months (p < 0.05). CONCLUSIONS: Survival improvement in group C might be attributable to the early start of combined radio-/chemotherapy. Therapy was administered on a complete outpatient basis, enabled by a dedicated interdisciplinary neuro-oncologic team caring for group C. Toxicity was mild and patients' acceptance excellent.
Authors:
Barbara Fazeny-Dörner; Anwar Gyries; Karl Rössler; Karl Ungersböck; Thomas Czech; Alexandra Budinsky; Monika Killer; Karin Dieckmann; Maria Piribauer; Gerhart Baumgartner; Daniela Prayer; Mario Veitl; Manfred Muhm; Christine Marosi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Wiener klinische Wochenschrift     Volume:  115     ISSN:  0043-5325     ISO Abbreviation:  Wien. Klin. Wochenschr.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-07-25     Completed Date:  2003-10-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  21620870R     Medline TA:  Wien Klin Wochenschr     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  389-97     Citation Subset:  IM    
Affiliation:
Clinical Division of Oncology & Ludwig Boltzmann Intitute for Clinical Experimental Oncology, Department of Medicine I, University of Vienna, Vienna, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Agents / administration & dosage,  therapeutic use
Antineoplastic Agents, Alkylating / administration & dosage,  therapeutic use
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Brain Neoplasms / drug therapy,  mortality*,  radiography,  radiotherapy,  surgery
Clinical Trials as Topic
Cobalt Radioisotopes / therapeutic use
Combined Modality Therapy
Dacarbazine / administration & dosage,  therapeutic use
Female
Glioblastoma / diagnosis,  drug therapy,  mortality*,  radiography,  radiotherapy,  surgery
Humans
Lomustine / administration & dosage,  therapeutic use
Magnetic Resonance Imaging
Male
Middle Aged
Nitrosourea Compounds / administration & dosage,  therapeutic use
Organophosphorus Compounds / administration & dosage,  therapeutic use
Radiotherapy Dosage
Survival Analysis
Time Factors
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Antineoplastic Agents, Alkylating; 0/Cobalt Radioisotopes; 0/Nitrosourea Compounds; 0/Organophosphorus Compounds; 13010-47-4/Lomustine; 4342-03-4/Dacarbazine; 92118-27-9/fotemustine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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