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Radiother Oncol. 2016 Jan;118(1):9-15. doi: 10.1016/j.radonc.2016.01.001. Epub 2016 Jan 11.

Delaying standard combined chemoradiotherapy after surgical resection does not impact survival in newly diagnosed glioblastoma patients.

Author information

1
Department of Radiation Oncology, INSERM 1030 "Molecular Radiotherapy", Gustave Roussy, Gustave Roussy Cancer Campus, Villejuif, France. Electronic address: guillaume.louvel@gustaveroussy.fr.
2
Department of Neurosurgery, Clairval Private Hospital, Marseille, France; UMR911, CRO2, Aix-Marseille Université, France.
3
Department of Radiotherapy, Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France; Radiobiology Laboratory, Federation of Translationnal Medicine de Strasbourg (FMTS), Strasbourg University, France.
4
Department of Neurosurgery, Sainte-Anne Hospital, Paris, France; Paris Descartes University, France.
5
Lyon Civil Hospitals, Pierre Wertheimer Neurological and Neurosurgical Hospital, Service of Neurosurgery D, France.
6
Department of Neurosurgery, Maison Blanche Hospital, Reims University Hospital, France.
7
Department of Neurosurgery, University Hospital Pontchaillou, Rennes, France.
8
Department of Neurosurgery, University Medical Center, Faculty of Medicine, University of Brest, France.
9
Department of Neurosurgery, APHP Beaujon Hospital, Clichy, France.
10
Department of Neurosurgery, Sainte Anne Military Teaching Hospital, Toulon, France.
11
Department of Neurosurgery, University Hospital Jean Minjoz, Besançon, France.
12
Departement of Neurosurgery, University Hospital of Caen, University of Lower Normandy, France.
13
Department of Neurosurgery, Pasteur Hospital, Colmar, France.
14
Department of Neurosurgery, Amiens University Hospital, France.
15
Department of Neurosurgery, CHU de Limoges, France.
16
Department of Neurosurgery A, CHU Pellegrin, Bordeaux Cedex, France.
17
Department of Neurosurgery, Clairval Private Hospital, Marseille, France.
18
Department of Neurosurgery, Rouen University Hospital, France.
19
Department of Neurosurgery, CHU d'Angers, France.
20
Department of Neurooncology, Gustave Roussy, Villejuif, France.
21
Department of Radiation Oncology, INSERM 1030 "Molecular Radiotherapy", Gustave Roussy, Gustave Roussy Cancer Campus, Villejuif, France.

Abstract

BACKGROUND:

To assess the influence of the time interval between surgical resection and standard combined chemoradiotherapy on survival in newly diagnosed and homogeneously treated (surgical resection plus standard combined chemoradiotherapy) glioblastoma patients; while controlling confounding factors (extent of resection, carmustine wafer implantation, functional status, neurological deficit, and postoperative complications).

METHODS:

From 2005 to 2011, 692 adult patients (434 men; mean of 57.5 ± 10.8 years) with a newly diagnosed glioblastoma were enrolled in this retrospective multicentric study. All patients were treated by surgical resection (65.5% total/subtotal resection, 34.5% partial resection; 36.7% carmustine wafer implantation) followed by standard combined chemoradiotherapy (radiotherapy at a median dose of 60 Gy, with daily concomitant and adjuvant temozolomide). Time interval to standard combined chemoradiotherapy was analyzed as a continuous variable and as a dichotomized variable using median and quartiles thresholds. Multivariate analyses using Cox modeling were conducted.

RESULTS:

The median progression-free survival was 10.3 months (95% CI, 10.0-11.0). The median overall survival was 19.7 months (95% CI, 18.5-21.0). The median time to initiation of combined chemoradiotherapy was 1.5 months (25% quartile, 1.0; 75% quartile, 2.2; range, 0.1-9.0). On univariate and multivariate analyses, OS and PFS were not significantly influenced by time intervals to adjuvant treatments. On multivariate analysis, female gender, total/subtotal resection and RTOG-RPA classes 3 and 4 were significant independent predictors of improved OS.

CONCLUSIONS:

Delaying standard combined chemoradiotherapy following surgical resection of newly diagnosed glioblastoma in adult patients does not impact survival.

KEYWORDS:

Glioblastoma; Prognostic factors; Radiotherapy; Standard combined chemoradiotherapy; Temozolomide; Time interval

PMID:
26791930
DOI:
10.1016/j.radonc.2016.01.001
[Indexed for MEDLINE]

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