Optimal Timing of Radiotherapy Following Gross Total or Subtotal Resection of Glioblastoma: A Real-World Assessment using the National Cancer Database.
Adolescent
Adult
Aged
Aged, 80 and over
Brain Neoplasms
/ epidemiology
Combined Modality Therapy
Databases, Factual
Disease Management
Female
Glioblastoma
/ epidemiology
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Public Health Surveillance
Time-to-Treatment
Treatment Outcome
Young Adult
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
18 03 2020
18 03 2020
Historique:
received:
07
11
2019
accepted:
19
02
2020
entrez:
20
3
2020
pubmed:
20
3
2020
medline:
24
11
2020
Statut:
epublish
Résumé
Treatment for glioblastoma (GBM) includes surgical resection and adjuvant radiotherapy (RT) and chemotherapy. The optimal time interval between surgery and RT remains unclear. The National Cancer Database (NCDB) was queried for patients with GBM. Overall survival (OS) was estimated using Kaplan-Meier and log-rank tests. Univariate (UVA) and multivariable Cox regression (MVA) modeling was used to determine predictors of OS. A total of 45,942 patients were included. On MVA: younger age, female gender, black ethnicity, higher KPS, obtaining a gross total resection (GTR), MGMT promoter-methylated gene status, unifocal disease, higher RT dose, and RT delay of 4-8 weeks had improved OS. Patients who underwent a subtotal resection (STR) had worsened survival with RT delay ≤4 weeks and patients with GTR had worsened survival when RT was delayed >8 weeks. This analysis suggests that an interval of 4-8 weeks between resection and RT results in better survival. Delays >8 weeks in patients with a GTR and delays <4 weeks in patients with a STR/biopsy resulted in worse survival. This impact of time delay from surgery to RT, in conjunction with extent of resection, should be considered in the clinical management of patients and future designs of clinical trials.
Identifiants
pubmed: 32188907
doi: 10.1038/s41598-020-61701-z
pii: 10.1038/s41598-020-61701-z
pmc: PMC7080722
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4926Subventions
Organisme : NIBIB NIH HHS
ID : R25 EB025787
Pays : United States
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