Radio-chemotherapy feasibility for biopsy-only unresectable
biopsy-only
glioblastoma
treatments
unresectable
Journal
Neuro-oncology practice
ISSN: 2054-2577
Titre abrégé: Neurooncol Pract
Pays: England
ID NLM: 101640528
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
pmc-release:
30
05
2024
medline:
27
11
2023
pubmed:
27
11
2023
entrez:
27
11
2023
Statut:
epublish
Résumé
"Biopsy-only" glioblastoma (BO-GBM) is a heterogeneous, understudied group of patients associated with a poor outcome. Our objective was to explore the pattern of care and prognosis associated with BO-GBM in our center. Patients with Of 535 patients included in the cohort, 137 patients were included in the present analysis. The median age was 66 years old and the median KPS was 70. Forty-six patients (33.6%) were referred to radiotherapy and chemotherapy (RT-TMZ) regimen, 75 (54.7%), considered unfitted for RT, received chemotherapy upfront (CT) and 16 (11.7%) were referred to palliative care (PC). Regarding the first group, 91% of patients completed the RT-TMZ. In the CT group, 11 of 75 patients (14.7%) underwent radiotherapy after chemotherapy upfront. Median overall survival was 12.3 months (95% CI, 15.30-24.16), 5.7 months (95% CI, 6.22-9.20), and 1.9 months (95% CI, 1.43-5.08) in RT-TMZ, CT, and PC groups, respectively. In multivariate analyses, progression-free survival was impacted by baseline KPS ( BO-GBM constitute a large and heterogeneous population in which one-third of patients is amenable to the standard of care, with survival outcome close to one of the patients who underwent surgery. Reliable criteria are needed to help select patients for adequate treatment while new strategies are warranted for BO-GBM unfit for RT.
Sections du résumé
Background
UNASSIGNED
"Biopsy-only" glioblastoma (BO-GBM) is a heterogeneous, understudied group of patients associated with a poor outcome. Our objective was to explore the pattern of care and prognosis associated with BO-GBM in our center.
Methods
UNASSIGNED
Patients with
Results
UNASSIGNED
Of 535 patients included in the cohort, 137 patients were included in the present analysis. The median age was 66 years old and the median KPS was 70. Forty-six patients (33.6%) were referred to radiotherapy and chemotherapy (RT-TMZ) regimen, 75 (54.7%), considered unfitted for RT, received chemotherapy upfront (CT) and 16 (11.7%) were referred to palliative care (PC). Regarding the first group, 91% of patients completed the RT-TMZ. In the CT group, 11 of 75 patients (14.7%) underwent radiotherapy after chemotherapy upfront. Median overall survival was 12.3 months (95% CI, 15.30-24.16), 5.7 months (95% CI, 6.22-9.20), and 1.9 months (95% CI, 1.43-5.08) in RT-TMZ, CT, and PC groups, respectively. In multivariate analyses, progression-free survival was impacted by baseline KPS (
Conclusion
UNASSIGNED
BO-GBM constitute a large and heterogeneous population in which one-third of patients is amenable to the standard of care, with survival outcome close to one of the patients who underwent surgery. Reliable criteria are needed to help select patients for adequate treatment while new strategies are warranted for BO-GBM unfit for RT.
Identifiants
pubmed: 38009116
doi: 10.1093/nop/npad028
pii: npad028
pmc: PMC10666802
doi:
Types de publication
Journal Article
Langues
eng
Pagination
536-543Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
J Clin Oncol. 2001 Oct 15;19(20):4037-47
pubmed: 11600605
Acta Neuropathol. 2016 Oct;132(4):625-34
pubmed: 27573687
J Clin Oncol. 2017 Jul 20;35(21):2439-2449
pubmed: 28640707
Ann Oncol. 2014 Jul;25(7):1442-1447
pubmed: 24723487
Prog Neurol Surg. 2018;30:1-11
pubmed: 29241168
Neurology. 2010 Oct 26;75(17):1560-6
pubmed: 20975057
J Cancer Res Clin Oncol. 2003 Aug;129(8):477-84
pubmed: 12884028
JAMA Oncol. 2020 Jul 1;6(7):1003-1010
pubmed: 32437507
Neuro Oncol. 2004 Jul;6(3):227-35
pubmed: 15279715
Cancer Chemother Pharmacol. 2017 Dec;80(6):1209-1217
pubmed: 29075855
J Clin Oncol. 1999 May;17(5):1516-25
pubmed: 10334539
Methods Mol Biol. 2009;472:323-42
pubmed: 19107440
Int J Radiat Oncol Biol Phys. 1998 Jan 1;40(1):51-5
pubmed: 9422557
Neuro Oncol. 2007 Jan;9(1):53-62
pubmed: 17018697
Neurosurg Rev. 2022 Jun;45(3):2339-2347
pubmed: 35194724
N Engl J Med. 2017 Nov 16;377(20):1954-1963
pubmed: 29141164
J Neurooncol. 2011 Sep;104(3):639-46
pubmed: 21468776
Neuro Oncol. 2003 Apr;5(2):89-95
pubmed: 12672280
N Engl J Med. 2014 Feb 20;370(8):699-708
pubmed: 24552317
Neuro Oncol. 2019 Nov 1;21(Suppl 5):v1-v100
pubmed: 31675094
Hum Pathol. 2010 Jun;41(6):815-23
pubmed: 20303140
J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):562-8
pubmed: 15774446
Bull Cancer. 2011 Mar;98(3):291-303
pubmed: 21459716
Ann Oncol. 2005 Jul;16(7):1177-84
pubmed: 15857844
N Engl J Med. 2017 Mar 16;376(11):1027-1037
pubmed: 28296618
Neuro Oncol. 2021 Aug 2;23(8):1231-1251
pubmed: 34185076
JAMA. 2017 Dec 19;318(23):2306-2316
pubmed: 29260225
Lancet Oncol. 2014 Sep;15(10):1100-8
pubmed: 25163906
J Clin Oncol. 1992 Jul;10(7):1074-7
pubmed: 1318951
Lancet Oncol. 2017 Oct;18(10):1373-1385
pubmed: 28844499
J Clin Oncol. 2010 Apr 10;28(11):1963-72
pubmed: 20231676
Acta Neuropathol. 2016 Jun;131(6):803-20
pubmed: 27157931
Int J Radiat Oncol Biol Phys. 2011 Nov 1;81(3):623-30
pubmed: 20888136
J Clin Oncol. 2003 Oct 15;21(20):3798-807
pubmed: 12953099
N Engl J Med. 2005 Mar 10;352(10):987-96
pubmed: 15758009
Cancer. 2016 Aug 1;122(15):2364-70
pubmed: 27172136
JAMA. 2005 Feb 2;293(5):557-64
pubmed: 15687310
N Engl J Med. 2014 Feb 20;370(8):709-22
pubmed: 24552318