Survival of glioblastoma treated with a moderately escalated radiation dose—Results of a retrospective analysis

Abstract

Glioblastoma (GBM) has the highest fatality rate among primary malignant brain tumors and typically tends to recur locally just adjacent to the original tumor site following surgical resection and adjuvant radiotherapy. We conducted a study to evaluate the survival outcomes between a standard dose (� 60 Gy) and moderate radiation dose escalation (>60 Gy), and to identify prognostic factors for GBM. We retrospectively reviewed the medical records of primary GBM patients diagnosed between 2005 and 2016 in two referral hospitals in Taiwan. They were identified from the cancer registry database and followed up from the date of diagnosis to October 2018. The progression-free survival (PFS) and overall survival (OS) were compared between the two dose groups, and independent factors for survival were analyzed through Cox proportional hazard model. We also affirmed the results using Cox regression with least absolute shrinkage and selection operator (LASSO) approach. From our cancer registry database, 142 GBM patients were identified, and 84 of them fit the inclusion criteria. Of the 84 patients, 52 (62%) were males. The radiation dose ranged from 50.0 Gy to 66.6 Gy, but their treatment volumes were similar to the others. Fifteen (18%) patients received an escalated dose boost >60.0 Gy. The escalated group had a longer median PFS (15.4 vs. 7.9 months, p = 0.01 for log-rank test), and a longer median OS was also longer in the escalation group (33.8 vs. 12.5 months, p <0.001) than the reference group. Following a multivariate analysis, the escalated dose was identified as a significant predictor for good prognosis (PFS: hazard ratio [HR] = 0.48, 95% confidence interval [95%CI]: 0.23-0.98; OS: HR = 0.40, 95%CI: 0.21-0.78). Using the LASSO approach, we found age > 70 (HR = 1.55), diagnosis after 2010 (HR = 1.42), and a larger radiation volume (� 250ml; HR = 0.81) were predictors of PFS. The escalated dose (HR = 0.47) and a larger radiation volume (HR = 0.76) were identified as predictors for better OS. Following detailed statistical analysis, a moderate radiation dose escalation (> 60 Gy) was found as an independent factor affecting

Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database

“…Further, the more recently defined subtype of epithelioid GBM, there were no registered case data in the study. It is well-known a younger age is significantly associated with good survival in conventional GBM patients in the literature (6,20,(26)(27)(28). A younger age experienced favorable survival in our GBM cohort.…”

Effects of miR-373 Inhibition on Glioblastoma Growth by Reducing Limk1 In Vitro

“…Currently, for the treatment on GBM patients, surgery and chemo- or radiotherapy were the main available methods [ 2 – 4 ]. But the resistance to chemo- or radiotherapy was the trouble of the clinical treatment on these patients, which may reduce therapeutic efficacy or enhance the toxicity to normal organs by increasing the therapeutic dosage with poor long-term survival for patients [ 41 , 42 ].…”

“…Glioblastoma is an aggressive brain tumor with shorter median overall survival time in adults [ 1 ], although multiple therapeutic methods have been used including surgical resection and chemo- or radiotherapy [ 2 , 3 ]. It has been reported that only a median survival of 15 months was obtained after radiotherapy combined with temozolomide (TMZ) [ 4 , 5 ], which was the major chemotherapy drug for GBM but with resistance effects for most patients yet [ 6 , 7 ].…”

Administration of Valproic Acid Improves the Survival of Patients with Glioma Treated with Postoperative Radiotherapy

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