Glioblastome Multiforme Epidemiyolojisi, Tedavi Seçenekleri ve Sağ Kalım Süresi: Retrospektif Tek Merkezli Çalışma

Abstract

Amaç: Glioblastoma multiforme (GBM), primer beyin tümörlerinin en sık görülenidir. Tedavisi ile ilgili çok sayıda klinik ve deneysel çalışma yapılmasına rağmen; GBM’in tedavi seçenekleri çok fazla değişmemiştir. Çalışmamız, GBM’li hastaların epidemiyolojisi, tedavi seçenekleri ve sağ kalım süreleri arasındaki ilişkiyi incelemek amacıyla planlandı. Gereç ve Yöntemler: Bu çalışmada, 2017-2019 yılları arasında Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi Beyin ve sinir cerrahisi Anabilim Dalı’nda GBM tanısı alan 72 hasta retroprospektif olarak değerlendirilmiştir. Bu hastaların tedavi modaliteleri, epidemiyolojileri ve sağ kalım süreleri incelenmiştir. Bulgular: Hastaların 28’i kadın, 44’ü erkek olup, %55.6’sı 60 yaş üstüdür. Cinsiyet ile sağ kalım süresi arasındaki fark istatistiksel olarak anlamlı değildir (p=0.303>0.05). Yaş arttıkça sağ kalım süresinde %28,9 oranında azalış olduğu görülmüştür. GBM lokalizasyon olarak en sık temporopariyatel yerleşimli olduğu gözlenirken, tümör lokalizasyonu ile sağ kalım süresi arasında anlamlı fark görülmedi. Sonuç: Çalışmamızın sonucunda GBM’li hastalarda, yaşın ve kombine tedavi seçeneğinin önemli bir prognostik faktörler olduğu görülmüştür.

Keywords

• Glioblastome Multiforme
• Radyoterapi
• Kemoterapi
• Epidemyoloji
• Ortalama sağkalım süresi

Epidemiology, Treatment Options and Survival Analysis of Glioblastoma Multiforme: A Retrospective Single Center Study

Abstract

Aim: Glioblastoma multiforme (GBM) is the most common of primary brain tumors. Although there are many clinical and experimental studies about its treatment; options for treatment of GBM have not changed much. Our study was planned to examine the relationship between epidemiologies, treatment options and survival times of patients with GBM. Materials and Methods: In this study, 72 patients diagnosed with GBM between 2017-2019 in Zonguldak Bülent Ecevit University Faculty of Medicine Department of Brain and Neurosurgery were evaluated retroprospectively. These patients’ treatment modalities, epidemiologies and survival times were examined. Results: 28 of the patients are female, 44 of them are male, 55.6% of them are over the age of 60. The difference in survival. The relationship between gender and survival time is not revealing (p=0.303>0.05) It was observed that the survival time decreased by 28.9% with increasing age. While GBM was observed most frequently temporoparietal settlement as localization, there was no significant difference between tumor localization and survival time. Conclusion: As a result of our study, it was observed that age and combined treatment options are important prognostic factors in patients with GBM.

Keywords

• Glioblastoma Multiforme
• Radiotherapy
• Chemotherapy
• Epidemiology
• Median survival time

References

1. 1. Tamimi AF, Juweid M. Epidemiology and outcome of glioblastoma. In: De Vleeschouwer S, editor. Glioblastoma [Internet]. Brisbane, Australia: Codon Publications; 2017. https://doi.org/10.15586/codon.glioblastoma.2017.ch8.
2. 2. Ohgaki H, Kleihues P. The definition of primary and secondary glioblastoma. Clin Cancer Res. 2012;19(4):764–772.
3. 3. Louis DN, Perry A, Reifenberger G, Von Deimling A, Figarella-Branger D, Cavenee WK et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta neuropathologica. 2016;131(6):803-820.
4. 4. Ostrom QT, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2013–2017. Neuro-Oncology. 2020;22(Supplement_1):1–96.
5. 5. Altinoz MA, Nalbantoglu J, Ozpinar A, Ozcan ME, Del Maestro RF, Elmaci I. From epidemiology and neurodevelopment to antineoplasticity. Medroxyprogesterone reduces human glial tumor growth in vitro and C6 glioma in rat brain in vivo. Clinical neurology and neurosurgery. 2018;173:20-30.
6. 6. Shahcheraghi SH, Zangui M, Lotfi M, Ghayour-Mobarhan M, Ghorbani A, Jaliani HZ, et al. Therapeutic potential of curcumin in the treatment of glioblastoma multiforme. Current Pharmaceutical Design. 2019;25(3):333-342.
7. 7. Huang B, Zhang H, Gu L, Ye B, Jian Z, Stary C, Xiong X. Advances in immunotherapy for glioblastoma multiforme. Journal of immunology research. 2017;1-11.
8. 8. Von Neubeck C, Seidlitz A, Kitzler HH, Beuthien-Baumann B, Krause M. Glioblastoma multiforme: emerging treatments and stratification markers beyond new drugs. The British journal of radiology. 2015;88(1053):20150354.

9. 9. Hamisch C, Ruge M, Kellermann S, Kohl AC, Duval I, Goldbrunner R, et al. Impact of treatment on survival of patients with secondary glioblastoma. Journal of Neuro-Oncology. 2017;133(2):309-313.
10. 10. Ahmadipour Y, Kaur M, Pierscianek D, Gembruch O, Oppong MD, Mueller O, et al. Association of surgical resection, disability, and survival in patients with glioblastoma. Journal of Neurological Surgery Part A: Central European Neurosurgery. 2019;80(04):262-268.
11. 11. Vuorinen V, Hinkka S, Färkkilä M, Jääskeläinen J. Debulking or biopsy of malignant glioma in elderly people - a randomised study. Acta Neurochir (Wien). 2003;145(1):5–10.
12. 12. Salgado MV, Torres J, Esteban J, Gutiérrez JA, Ley L, Carrato A. Survey of treatment recommendations for elderly patients with glioblastoma. Clinical and Translational Oncology. 2020;22:1329–1334.
13. 13. Sanai N, Berger MS. Glioma extent of resection and its impact on patient outcome. Neurosurgery. 2008;62(4):753–764.
14. 14. Stupp R, Mason WP, Van Den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. New England journal of medicine. 2005;352(10):987-996.
15. 15. Carlsson SK, Brothers SP, Wahlestedt D. Emerging treatment strategies for glioblastoma multiforme. EMBO Mol. Med. 2014;6(11):1359-1370.
16. 16. Ampie L, Woolf EC, Dardis C. Immunotherapeutic advancements for glioblastoma. Front Oncol. 2015;5:12.
17. 17. Batash R, Asna N, Schaffer P, Francis N, Schaffer M (2017). Glioblastoma multiforme, diagnosis and treatment; recent literature review. Current medicinal chemistry. 2017;24(27):3002-3009.
18. 18. Nieder C, Astner ST, Mehta MP, Grosu AL, Molls M. Improvement, clinical course, and quality of life after palliative radiotherapy for recurrent glioblastoma. Am. J. Clin. Oncol. 2008;31:300-305.
19. 19. Malmström A, Grøonberg BH, Marosi C, Stupp R, Frappaz D, Schultz H, Abacioglu U, Tavelin B, Lhermitte B, Hegi ME, Rosell J, Henriksson R. Nordic Cinical Brain Tumour Study Group (NCBTSG). Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol. 2012;13(9):916-926.
20. 20. Beal K, Abrey LE, Gutin PH. Antiangiogenic agents in the treatment of recurrent or newly diagnosed glioblastoma: analysis of single-agent and combined modality approaches. Radiat Oncol Lond Engl. 2011;6:2.
21. 21. Torres S, Lorente M, Rodriguez-Fornes F, HernandezTiedra S, Salazar M, Garcia-Taboada E, Barcia J, Guzman M, Velasco G. A combined preclinical therapy of cannabinoids and temozolomide against glioma. Mol Cancer Ther. 2011;10(Suppl. 1):90-103.
22. 22. Mantwill K, Naumann U, Seznec J, Girbinger V, Lage H, Surowiak P, Beier D, Mittelbronn M, Schlegel J, Holm PS. YB-1 dependent oncolytic adenovirus efficiently inhibits tumor growth of glioma cancer stem like cells. J Trans Med. 2013;11:216.
23. 23. Hoffmann D, Wildne, O. Comparison of herpes simplex virus- and conditionally replicative adenovirus-based vectors for glioblastoma treatment. Cancer Gene Ther. 2007;14(7):627-639.
24. 24. Stupp R, Wong E, Scott C, et al. NT-40Interim analysis of the EF-14 Trial: A prospective, multi-center trial of NovoTTF-100A together with temozolomide compared to temozolomide alone in patients with newly Diagnosed GBM. Neuro-Oncology. 2014;16:v167. 25. Vuorinen V, Hinkka S, Färkkilä M, Jääskeläinen J. Debulking or biopsy of malignant glioma in elderly people–a randomised study. Acta neurochirurgica. 2003;145(1):5-10.
25. 26. Ghosh M, Shubham S, Mandal K, Trivedi V, Chauhan R, Naseera S. Survival and prognostic factors for glioblastoma multiforme: Retrospective single-institutional study. Indian journal of cancer. 2017;54(1):362.
26. 27. Brown TJ, Brennan MC, Li M, Church EW, Brandmeir NJ, Rakszawski KL, et al. Association of the extent of resection with survival in glioblastoma: A Systematic review and meta-analysis. JAMA Oncol. 2016;2:1460-1469.
27. 28. Keime-Guibert F, Chinot O, Taillandier L, Cartalat-Carel S, Frenay M, Kantor, G, Delattre JY. Radiotherapy for glioblastoma in the elderly. New england journal of medicine. 2007;356(15):1527-1535.
28. 29. Stupp R, Mason WP, Van Den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. New England journal of medicine. 2005;352(10):987-996.
29. 30. Stupp R, Hegi ME, Mason WP, Van Den Bent MJ, Taphoorn MJ, Janzer RC, et al. National Cancer Institute of Canada Clinical Trials Group. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. The lancet oncology. 2009;10(5):459-466.
30. 31. Simińska D, Korbecki J, Kojder K, Kapczuk P, Fabiańska M, Gutowska I, et al. Epidemiology of Anthropometric Factors in Glioblastoma Multiforme—Literature Review. Brain Sciences. 2021;11(1):116.
31. 32. Tian M, Ma W, Chen Y, Yu Y, Zhu D, Shi J, Zhang Y. Impact of Gender on the Survival of Patients with Glioblastoma. Biosci. Rep. 2018;38.
32. 33. Shabihkhani M, Telesca D, Movassaghi M, Naeini YB, Naeini KM, Hojat SA, et al. Incidence, survival, pathology, and genetics of adult Latino Americans with glioblastoma. Journal of neuro-oncology. 2017;132(2):351-358.
33. 34. Ohgaki H, Dessen P, Jourde B, Horstmann S, Nishikawa T, Di Patre PL, et al. Genetic pathways to glioblastoma: a population-based study. Cancer research. 2004;64(19):6892-6899.
34. 35. Li K, Lu D, Guo Y, Wang C, Liu X, Liu Y, Liu D. Trends and Patterns of Diffuse Glioma in the United States, 1973–2014. Cancer Med. 2018;7:5281–5290.