Patterns of care in recurrent glioblastoma in Switzerland: a multicentre national approach based on diagnostic nodes
| Autor: | Pierre-Yves Dietrich, Katrin Conen, Alessia Pica, Denis Migliorini, Thomas Hundsberger, Patrick Roth, Ludwig Plasswilm, Michael Weller, E. Hermann, G. Pesce, Detlef Brügge, Andreas F. Hottinger, Ulrich Roelcke, Paul Martin Putora, Markus W Gross |
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| Přispěvatelé: | University of Zurich, Hundsberger, T |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Bevacizumab 610 Medicine & health Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Multidisciplinary approach medicine Humans Combined Modality Therapy 1306 Cancer Research Intensive care medicine Antineoplastic Agents Alkylating Aged ddc:616 Temozolomide Brain Neoplasms business.industry Recurrent glioblastoma Second opinion Middle Aged Prognosis 10040 Clinic for Neurology Surgery Clinical trial Institutional repository 2728 Neurology (clinical) Treatment Outcome Neurology Oncology 2808 Neurology 030220 oncology & carcinogenesis 2730 Oncology Female Neurology (clinical) Neoplasm Recurrence Local Glioblastoma business Switzerland 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of Neuro-Oncology, Vol. 126, No 1 (2016) pp. 175-183 Hundsberger, T.; Hottinger, A. F.; Roelcke, U.; Roth, P.; Migliorini, D.; Dietrich, P. Y.; Conen, K.; Pesce, G.; Herrmann, Evelyn; Pica, Alessia; Gross, M. W.; Brügge, D.; Plasswilm, Ludwig; Weller, M.; Putora, P. M. (2016). Patterns of care in recurrent glioblastoma in Switzerland: a multicentre national approach based on diagnostic nodes. Journal of neuro-oncology, 126(1), pp. 175-183. Springer 10.1007/s11060-015-1957-0 |
| ISSN: | 0167-594X |
| DOI: | 10.1007/s11060-015-1957-0 |
| Popis: | Despite moderate improvements in outcome of glioblastoma after first-line treatment with chemoradiation recent clinical trials failed to improve the prognosis of recurrent glioblastoma. In the absence of a standard of care we aimed to investigate institutional treatment strategies to identify similarities and differences in the pattern of care for recurrent glioblastoma. We investigated re-treatment criteria and therapeutic pathways for recurrent glioblastoma of eight neuro-oncology centres in Switzerland having an established multidisciplinary tumour-board conference. Decision algorithms, differences and consensus were analysed using the objective consensus methodology. A total of 16 different treatment recommendations were identified based on combinations of eight different decision criteria. The set of criteria implemented as well as the set of treatments offered was different in each centre. For specific situations, up to 6 different treatment recommendations were provided by the eight centres. The only wide-range consensus identified was to offer best supportive care to unfit patients. A majority recommendation was identified for non-operable large early recurrence with unmethylated MGMT promoter status in the fit patients: here bevacizumab was offered. In fit patients with late recurrent non-operable MGMT promoter methylated glioblastoma temozolomide was recommended by most. No other majority recommendations were present. In the absence of strong evidence we identified few consensus recommendations in the treatment of recurrent glioblastoma. This contrasts the limited availability of single drugs and treatment modalities. Clinical situations of greatest heterogeneity may be suitable to be addressed in clinical trials and second opinion referrals are likely to yield diverging recommendations. |
| Databáze: | OpenAIRE |
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