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Journal Articles Radiotherapy & Oncology Year : 2016

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

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Philippe Metellus
  • Function : Author
  • PersonId : 1002610
Georges Noel
  • Function : Author
  • PersonId : 948509
Olivier Langlois
Philippe Menei
  • Function : Author
  • PersonId : 910996
  • IdRef : 076585468
Johan Pallud

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.
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Dates and versions

hal-02042644 , version 1 (20-02-2019)

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Guillaume Louvel, Philippe Metellus, Georges Noel, Sophie Peeters, Jacques Guyotat, et al.. Delaying standard combined chemoradiotherapy after surgical resection does not impact survival in newly diagnosed glioblastoma patients. Radiotherapy & Oncology, 2016, 118 (1), pp.9-15. ⟨10.1016/j.radonc.2016.01.001⟩. ⟨hal-02042644⟩
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