Association of patterns of care, prognostic factors, and use of radiotherapy–temozolomide therapy with survival in patients with newly diagnosed glioblastoma: a French national population-based study

Autor: Faiza Bessaoud, Johan Pallud, Sonia Zouaoui, Valérie Rigau, Hugues Duffau, Adeline Riondel, Brigitte Trétarre, Pascale Fabbro-Peray, Emmanuel Mandonnet, Luc Taillandier, M. Charissoux, Amélie Darlix, Dominique Figarella-Branger, Hélène Mathieu-Daudé, L. Bauchet, Elodie Sorbets, Fabienne Bauchet, Michel Fabbro, Aymeric Amelot
Přispěvatelé: Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut des Neurosciences de Montpellier (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut du Cancer de Montpellier (ICM), Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'ophthalmologie [CHU Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Hôpital Lariboisière-Fernand-Widal [APHP], CHU Marseille, Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Gui de Chauliac [Montpellier], Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP)
Rok vydání: 2018
Předmět:
Male
Oncology
Cancer Research
Databases
Factual
medicine.medical_treatment
0302 clinical medicine
Risk of mortality
Practice Patterns
Physicians'
Aged
80 and over
education.field_of_study
Brain Neoplasms
Middle Aged
Prognosis
Combined Modality Therapy
3. Good health
Survival Rate
Neurology
030220 oncology & carcinogenesis
Female
France
Neurosurgery
medicine.drug
Cohort study
Adult
medicine.medical_specialty
Population
03 medical and health sciences
Internal medicine
Neuro-oncology
Temozolomide
medicine
Humans
education
Antineoplastic Agents
Alkylating
Population-based study
Aged
business.industry
Clinical epidemiology
Confidence interval
Radiation therapy
Concomitant
Clinical Study
Neurology (clinical)
Glioblastoma
business
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
030217 neurology & neurosurgery
Zdroj: Journal of Neuro-Oncology
Journal of Neuro-Oncology, 2019, 142 (1), pp.91-101. ⟨10.1007/s11060-018-03065-z⟩
Journal of Neuro-Oncology, Springer Verlag, 2019, 142 (1), pp.91-101. ⟨10.1007/s11060-018-03065-z⟩
ISSN: 1573-7373
0167-594X
DOI: 10.1007/s11060-018-03065-z
Popis: Background Glioblastoma is the most frequent primary malignant brain tumor. In daily practice and at whole country level, oncological care management for glioblastoma patients is not completely known. Objectives To describe oncological patterns of care, prognostic factors, and survival for all patients in France with newly-diagnosed and histologically confirmed glioblastoma, and evaluate the impact of extended temozolomide use at the population level. Methods Nationwide population-based cohort study including all patients with newly-diagnosed and histologically confirmed glioblastoma in France in 2008 and followed until 2015. Results Data from 2053 glioblastoma patients were analyzed (male/female ratio 1.5, median age 64 years). Median overall survival (OS) was 11.2 [95% confidence interval (CI) 10.7–11.9] months. The first-line therapy and corresponding median survival (MS, in months) were: 13% did not receive any oncological treatment (biopsy only) (MS = 1.8, 95% CI 1.6–2.1), 27% received treatment without the combination of radiotherapy (RT)–temozolomide (MS = 5.9, 95% CI 5.5–6.6), 60% received treatment including the initiation of the concomitant phase of RT–temozolomide (MS = 16.4, 95% CI 15.2–17.4) whom 44% of patients initiated the temozolomide adjuvant phase (MS = 18.9, 95% CI 18.0–19.8). Only 22% patients received 6 cycles or more of adjuvant temozolomide (MS = 25.5, 95% CI 24.0–28.3). The multivariate analysis showed that the risk of mortality was significantly higher for the non-progressive patients who stopped at 6 cycles (standard protocol) than those who continued the treatment, hazard ratio = 1.5 (95% CI 1.2–1.9). Conclusion In non-progressive patients, prolonging the adjuvant temozolomide beyond 6 cycles may improve OS. Electronic supplementary material The online version of this article (10.1007/s11060-018-03065-z) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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