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Chemoirradiation for glioblastoma multiforme: the national cancer institute experience.

Ho J, Ondos J, Ning H, Smith S, Kreisl T, Iwamoto F, Sul J, Kim L, McNeil K, Krauze A, Shankavaram U, Fine HA, Camphausen K - PLoS ONE (2013)

Bottom Line: Topographic locations were classified using preoperative imaging.At a median follow-up of 18.7 months, the median overall survival (OS) and progression-free survival (PFS) for all patients was 17.9 and 7.6 months.The patients who received bevacizumab after recurrence had a median OS of 23.3 months, compared to 16.3 months in patients who did not receive it, P = 0.0284.

View Article: PubMed Central - PubMed

Affiliation: Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.

ABSTRACT

Purpose: Standard treatment for glioblastoma (GBM) is surgery followed by radiation (RT) and temozolomide (TMZ). While there is variability in survival based on several established prognostic factors, the prognostic utility of other factors such as tumor size and location are not well established.

Experimental design: The charts of ninety two patients with GBM treated with RT at the National Cancer Institute (NCI) between 1998 and 2012 were retrospectively reviewed. Most patients received RT with concurrent and adjuvant TMZ. Topographic locations were classified using preoperative imaging. Gross tumor volumes were contoured using treatment planning systems utilizing both pre-operative and post-operative MR imaging.

Results: At a median follow-up of 18.7 months, the median overall survival (OS) and progression-free survival (PFS) for all patients was 17.9 and 7.6 months. Patients with the smallest tumors had a median OS of 52.3 months compared to 16.3 months among patients with the largest tumors, P = 0.006. The patients who received bevacizumab after recurrence had a median OS of 23.3 months, compared to 16.3 months in patients who did not receive it, P = 0.0284. The median PFS and OS in patients with periventricular tumors was 5.7 and 17.5 months, versus 8.9 and 23.3 months in patients with non-periventricular tumors, P = 0.005.

Conclusions: Survival in our cohort was comparable to the outcome of the defining EORTC-NCIC trial establishing the use of RT+TMZ. This study also identifies several potential prognostic factors that may be useful in stratifying patients.

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Related in: MedlinePlus

Overall survival of patients who received bevacizumab after progression compared to those who didn’t.Patients receiving bevacizumab had a median OS of 23.3 months (95% CI: 17.1–35.6), compared to 16.3 months (95% CI: 13.8–25.1) in patients who did not receive it, P = 0.0284.
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pone-0070745-g003: Overall survival of patients who received bevacizumab after progression compared to those who didn’t.Patients receiving bevacizumab had a median OS of 23.3 months (95% CI: 17.1–35.6), compared to 16.3 months (95% CI: 13.8–25.1) in patients who did not receive it, P = 0.0284.

Mentions: Of the 70 patients who progressed, 62 continued to be followed at the NIH. Of those patients, 28 received bevacizumab after their first progression, either as mono-therapy or as part of combination therapy, and 34 did not receive bevacizumab after their first progression. Using log rank analysis, the patients who received bevacizumab had a significant improvement in overall survival. Patients receiving bevacizumab had a median OS of 23.3 months (95% CI: 17.1–35.6), compared to 16.3 months (95% CI: 13.8–25.1) in patients who did not receive it, P = 0.0284,Fig. 3. On multivariate analysis using bevacizumab usage, age, resection status and tumor location, bevacizumab usage was statistically significant, P = 0.04, Table 4.


Chemoirradiation for glioblastoma multiforme: the national cancer institute experience.

Ho J, Ondos J, Ning H, Smith S, Kreisl T, Iwamoto F, Sul J, Kim L, McNeil K, Krauze A, Shankavaram U, Fine HA, Camphausen K - PLoS ONE (2013)

Overall survival of patients who received bevacizumab after progression compared to those who didn’t.Patients receiving bevacizumab had a median OS of 23.3 months (95% CI: 17.1–35.6), compared to 16.3 months (95% CI: 13.8–25.1) in patients who did not receive it, P = 0.0284.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3733728&req=5

pone-0070745-g003: Overall survival of patients who received bevacizumab after progression compared to those who didn’t.Patients receiving bevacizumab had a median OS of 23.3 months (95% CI: 17.1–35.6), compared to 16.3 months (95% CI: 13.8–25.1) in patients who did not receive it, P = 0.0284.
Mentions: Of the 70 patients who progressed, 62 continued to be followed at the NIH. Of those patients, 28 received bevacizumab after their first progression, either as mono-therapy or as part of combination therapy, and 34 did not receive bevacizumab after their first progression. Using log rank analysis, the patients who received bevacizumab had a significant improvement in overall survival. Patients receiving bevacizumab had a median OS of 23.3 months (95% CI: 17.1–35.6), compared to 16.3 months (95% CI: 13.8–25.1) in patients who did not receive it, P = 0.0284,Fig. 3. On multivariate analysis using bevacizumab usage, age, resection status and tumor location, bevacizumab usage was statistically significant, P = 0.04, Table 4.

Bottom Line: Topographic locations were classified using preoperative imaging.At a median follow-up of 18.7 months, the median overall survival (OS) and progression-free survival (PFS) for all patients was 17.9 and 7.6 months.The patients who received bevacizumab after recurrence had a median OS of 23.3 months, compared to 16.3 months in patients who did not receive it, P = 0.0284.

View Article: PubMed Central - PubMed

Affiliation: Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.

ABSTRACT

Purpose: Standard treatment for glioblastoma (GBM) is surgery followed by radiation (RT) and temozolomide (TMZ). While there is variability in survival based on several established prognostic factors, the prognostic utility of other factors such as tumor size and location are not well established.

Experimental design: The charts of ninety two patients with GBM treated with RT at the National Cancer Institute (NCI) between 1998 and 2012 were retrospectively reviewed. Most patients received RT with concurrent and adjuvant TMZ. Topographic locations were classified using preoperative imaging. Gross tumor volumes were contoured using treatment planning systems utilizing both pre-operative and post-operative MR imaging.

Results: At a median follow-up of 18.7 months, the median overall survival (OS) and progression-free survival (PFS) for all patients was 17.9 and 7.6 months. Patients with the smallest tumors had a median OS of 52.3 months compared to 16.3 months among patients with the largest tumors, P = 0.006. The patients who received bevacizumab after recurrence had a median OS of 23.3 months, compared to 16.3 months in patients who did not receive it, P = 0.0284. The median PFS and OS in patients with periventricular tumors was 5.7 and 17.5 months, versus 8.9 and 23.3 months in patients with non-periventricular tumors, P = 0.005.

Conclusions: Survival in our cohort was comparable to the outcome of the defining EORTC-NCIC trial establishing the use of RT+TMZ. This study also identifies several potential prognostic factors that may be useful in stratifying patients.

Show MeSH
Related in: MedlinePlus