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Introduction: Fifty percent of glioblastoma patients are < 65 years old. We report our experience with younger patients with glioblastoma treated our tertiary care center. Materials and Methods: With IRB approval, the Cleveland Clinic’s database was used to identify glioblastoma patients treated through 2000 - 2015. Overall survival (OS) from the diagnosis of glioblastoma was the primary end point. Cox proportional hazard models with stepwise variable selections were used for data analysis. Results: 598 patients whose age were less than 65 years old were analyzed. The estimated median survival was 14 months, and the 1-year survival was 60.9% ± 2.0%, the 2-year survival was 25.5% ± 1.8% and 5-year survival was 2.3% ± 0.7%. The estimated median progression-free survival (PFS) was 7 months, and the 1-year PFS was 31.3% ± 1.9%, the 2-year PFS was 11.6% ± 1.3% and 5-year PFS was 0.6% ± 0.3%. The OS and PFS were found to be different between treatment groups.: Compared to the RT treatment only group, the RT+chemo group and chemo group were had a significantly better OS and PFS, and the results hold true with the adjustment of other facts in the multivariable analysis. 93.1% of patients had 1st line treatment; 57.5% of patients had 2nd line treatment; and 37.1% of patients had 3rd line treatment. The MGMT mutation had a significant associated with overall survival and a marginal association with progression-free survival. That is patients with MGMT mutation had a low risk of death/progression compared to those without MGMT. Compared to biopsy only surgery, GTR and STR had a significantly lower risk of death/progression with /without the adjustment of other factors. Patients whose age were between 50 -55 had no different OS and PFS compared to age < 50; age between 56-60 had a higher risk of death or progression compared to 50-55 group. And age between 60-65 had no different than the group between 65 – 60. Conclusions: Aggressive treatment with chemoradiation is associated with better outcomes in younger GBM, particularly in MGMT methylated population. |
