The survival significance of a measurable enhancing lesion after completing standard treatment for newly diagnosed glioblastoma |
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| Institution: | 1. Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, 103 Daehak-ro, Jongno-gu, Seoul 03080, South Korea;2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea;3. Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea;4. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea;5. Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea;6. Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea;7. Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea;8. Department of Neurosurgery, Gyeongsang National University School of Medicine, Changwon Gyeongsang National University Hospital, Changwon, South Korea;9. Department of Neurosurgery, Seoul National University Boramae Medical Center, Seoul, South Korea;1. Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel;2. Department of Neurosurgery, Sheba Medical Center, Tel-Hashomer, Israel;3. Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel-Hashomer, Israel;1. Department of Neuromodulation and Neurosurgery, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka Prefecture 565-0871, Japan;2. Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka Prefecture, Japan;3. Department of Neurosurgery, Hanwa Memorial Hospital, Sumiyoshi Ward, Osaka, Osaka Prefecture, Japan;4. Department of Neurosurgery, National Hospital Organization Osaka National Hospital, Chuo Ward, Osaka, Osaka Prefecture, Japan;5. Yuguchi Neurosurgical and Spine Clinic, Tennoji Ward, Osaka, Osaka Prefecture, Japan;1. Department of Nerve Function, Shengjing Hospital of China Medical University, Shenyang, China;2. Department of Neurology, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang 110004, China;1. Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;2. Department of Bariatric & Metabolic Care, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan |
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| Abstract: | The goal of this study was to analyze the survival outcome according to the treatment response after completing standard treatment protocol for newly diagnosed glioblastoma (GBM) and to suggest a patient who should be considered for further treatment. After approving by our Institutional Review Board, 57 patients (38 male, 19 female; median age, 52 years; age range, 16–81 years) with newly diagnosed GBM who completed standard treatment protocol were examined retrospectively. According to the treatment response using the RANO criteria, there were 20 patients with complete response (CR), five patients with partial response (PR), 13 patients with stable disease (SD) and 19 patients with progressive disease (PD) after the completion of standard treatment. Patients (PR + SD + PD) with a measurable enhancing lesion were categorized the MEL group (n = 37). We analyzed the difference of survival outcome between CR group and MEL group. The median progression-free survival (PFS) in the CR group was significantly better than that of the MEL group (18.0 months vs. 3.0 months, p = 0.004). The median overall survival (OS) was also significantly longer in the CR group (25.0 months vs. 15.0 months, p = 0.005). However, there was no significant difference in the survival outcome of the CR group compared with that of the subset of MEL group patients who showed PR or SD. Poor survival outcome was found only in MEL group patients who exhibited progression. Patients with a measurable enhancing lesion showing progression after completion of standard treatment protocol are appropriate candidates for further treatment. |
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| Keywords: | Adjuvant temozolomide Glioblastoma Measurable enhancing lesion Prolonged temozolomide Standard treatment |
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