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Clinical characterization of glioblastoma patients living longer than 2 years: A retrospective analysis of two Italian institutions
Author(s) -
Anselmo Paola,
Maranzano Ernesto,
Selimi Adelina,
Lupattelli Marco,
Palumbo Isabella,
Bini Vittorio,
Casale Michelina,
Trippa Fabio,
Bufi Alessandro,
Arcidiacono Fabio,
Aristei Cynthia
Publication year - 2021
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.13457
Subject(s) - medicine , temozolomide , concomitant , glioblastoma , multivariate analysis , radiation therapy , adjuvant , retrospective cohort study , surgery , chemotherapy , oncology , cancer research
Aim : Despite the advances in surgery and radio‐chemotherapy, the prognosis of glioblastoma (GBM) remains poor with about 13% of patients alive at 24 months. Methods : A total of 75 long‐term survivors (LTS), defined as alive at least 24 months from diagnosis, were retrospectively analyzed. Overall survival (OS) and recurrence‐free‐survival (RFS) were calculated and related to patient characteristics and treatment received. Results : Median age and Karnofsky performance status (KPS) were 56 years and 100%, respectively. After surgery (gross tumor resection‐GTR in 62, 83% patients), all LTS received concomitant temozolomide (TMZ) with radiotherapy and 70 (93%) adjuvant TMZ. Of these, 10 (13%) discontinued TMZ prior the completion of 6 cycles, 37 (49%) received 6 cycles and 23 (31%) >6 cycles. Sixty‐nine (92%) patients experienced a first tumor recurrence at a median time of 21 months. Of these, 32 (46%) were submitted to a second surgery, 34 (49%) to other no‐surgical treatments and 3 (5%) only supportive care. At multivariate analysis, OS was significantly improved by second surgery after first recurrence ( P = 0.0032) and by cycles of adjuvant TMZ > 6 versus ≤6 ( P = 0.05). More than six cycles of TMZ significantly conditioned also first RFS ( P = 0.011) and second RFS ( P = 0.033). Conclusion : The large majority of LTS had <65 years, had a high KPS and received GTR. OS and RFS resulted significantly related to an extended administration of adjuvant TMZ (>6 cycles) and a second surgery in case of recurrence.