Recurrent glioblastoma: which treatment? A real-world study from the Neuro-oncology Unit "Regina Elena" National Cancer Institute.

Autor: Villani V; Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 54, 00144, Rome, Italy., Prosperini L; Department of Neurosciences, San Camillo-Forlanini Hospital, Rome, Italy., Lecce M; Neurosurgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy., Tanzilli A; Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 54, 00144, Rome, Italy. antonio.tanzilli@ifo.it., Farneti A; Radiotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy., Benincasa D; Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 54, 00144, Rome, Italy., Telera S; Neurosurgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy., Marucci L; Radiotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy., Piludu F; Neuroradiology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy., Pace A; Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 54, 00144, Rome, Italy.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2022 Sep; Vol. 43 (9), pp. 5533-5541. Date of Electronic Publication: 2022 May 31.
DOI: 10.1007/s10072-022-06172-y
Abstrakt: Background: The majority of patients with glioblastoma (GBM) experience disease progression. At recurrence, treatment options have limited efficacy. Many studies report a limited and short duration response rate. Although clinical trials represent the "gold standard" for providing evidence on efficacy of specific treatment strategies, real-world data can be considered more representative of the "real" GBM population.
Objective: To describe the management of GBM recurrence in a large real-world sample.
Methods: We analysed retrospectively the data stored in the database of the Neuro-oncology Unit, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy. We considered only data of patients with histological diagnosis of GBM and disease recurrence during their follow-up. We excluded patients who did not receive treatment after the diagnosis.
Results: We analysed 422 patients (64% males, 36% females) with a mean age of 59.6 (range 16-87) years. At GBM recurrence, 135 (32.0%) patients underwent palliative care, and 287 (68.0%) underwent other treatments. Patients on palliative care were older, had a worse performance status, and a shorter time between GBM diagnosis and its recurrence. Patients who received chemotherapy in combination with other treatments (surgery and/or radiation therapy) at GBM recurrence had a longer survival than those in palliative care (p < 0.001). Surgery or radiation therapy alone did not have any effect on survival as compared with palliative care (p < 0.001).
Conclusion: This study confirms the importance of a multidisciplinary approach even at GBM recurrence, suggesting that combination treatments play a key role in management of disease.
(© 2022. Fondazione Società Italiana di Neurologia.)
Databáze: MEDLINE
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