In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 2 ( 2023-2-2), p. e0281166-
Abstract:
Therapy of recurrent glioblastoma (GBM) is challenging due to lack of standard treatment. We investigated physicians’ treatment choice at recurrence and prognostic and predictive factors for survival in GBM patients from Norway’s two largest regional hospitals. Clinicopathological data from n = 467 patients treated at Haukeland and Oslo university hospitals from January 2015 to December 2017 was collected. Data included tumour location, promoter methylation of O 6 methylguanine-DNA methyltransferase ( MGMT ) and mutation of isocitrate dehydrogenase ( IDH ), patient age, sex, extent of resection at primary diagnosis and treatment at successive tumour recurrences. Cox-proportional hazards regression adjusting for multiple risk factors was used. Median overall survival (OS) was 12.1 months and 21.4% and 6.8% of patients were alive at 2 and 5 years, respectively. Median progression-free survival was 8.1 months. Treatment at recurrence varied but was not associated with difference in overall survival (OS) ( p = 0.201). Age, MGMT hypermethylation, tumour location and extent of resection were independent prognostic factors. Patients who received 60 Gray radiotherapy with concomitant and adjuvant temozolomide at primary diagnosis had 16.1 months median OS and 9.3% were alive at 5 years. Patients eligible for gamma knife/stereotactic radiosurgery alone or combined with chemotherapy at first recurrence had superior survival compared to chemotherapy alone ( p 〈 0.001). At second recurrence, combination chemotherapy with or without bevacizumab were both superior to no treatment. Treatment at recurrence differed between the institutions but there was no difference in median OS, indicating that it is the disease biology that dictates patient outcome.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0281166
DOI:
10.1371/journal.pone.0281166.g001
DOI:
10.1371/journal.pone.0281166.g002
DOI:
10.1371/journal.pone.0281166.t001
DOI:
10.1371/journal.pone.0281166.t002
DOI:
10.1371/journal.pone.0281166.t003
DOI:
10.1371/journal.pone.0281166.s001
DOI:
10.1371/journal.pone.0281166.s002
DOI:
10.1371/journal.pone.0281166.s003
DOI:
10.1371/journal.pone.0281166.r001
DOI:
10.1371/journal.pone.0281166.r002
DOI:
10.1371/journal.pone.0281166.r003
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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