The Effect of Adjuvant Chemoradiotherapy Initiation Time on Prognosis in Glioblastoma Multiforme

Abstract

Objectives: To determine survival and investigate associated prognostic factors in glioblastoma multiforme (GBM) patients receiving adjuvant therapy. Materials and Methods: The study population comprised patients with isocitrate dehydrogenase wild-type GBM who were September 2022 and 1 March 2024. The primary endpoint was overall survival (OS), while the secondary endpoint was progression-free survival. Comparisons between groups were conducted using the log-rank test, and multivariate analyses were performed using Cox regression. Results: A total of 67 patients were evaluated. The median OS of patients was 19.3 months [95% confidence interval (CI) 15.1 to not reached (NR)]. A total of 60 patients (89.1%) underwent adjuvant treatment. The median OS was 31.1 months (95% CI 19.3 to NR) for patients treated within the first four weeks, 15.7 months (95% CI 15.1 to NR) for those treated within four to six weeks, and 11.3 months (95% CI 9.8 to NR) for those treated after six weeks. Conclusion: The observed survival rate in our study was comparable to that reported in clinical trials. However, the survival rate was significantly lower in patients who received treatment at a later stage. Therefore, further studies with larger patient populations are recommended to ensure that the guidelines more accurately reflect the timing of adjuvant therapy in GBM patients.

Keywords

• Glioblastoma multiforme
• stupp protocol
• overall survival
• time to treatment

Ethical Statement

Ethics Committee Approval: This study was approved by the Scientific Research Evaluation and Ethics Committee of Etlik City Hospital (decision no.: AEŞH-BADEK-2024-758, date: 02.10.2024). Informed Consent: Consent was not obtained since it was a retrospective study

Glioblastoma Multiformede Adjuvan Kemoradyoterapi Başlama Zamanının Prognoz Üzerine Etkisi

Abstract

Amaç: Bu çalışmanın amacı adjuvan tedavi alan glioblastoma multiforme (GBM) hastalarında sağkalımı belirlemek ve ilişkili prognostik faktörleri araştırmaktır. Gereç ve Yöntem: Çalışma popülasyonu, 1 Eylül 2022 ve 1 Mart 2024 tarihleri arasında kaydedilen izositrat dehidrogenaz vahşi tip GBM hastalarından oluşmaktadır. Birincil sonlanım noktası genel sağkalım, ikincil sonlanım noktası ise progresyonsuz sağkalımdır. Gruplar arasındaki karşılaştırmalar log-rank testi kullanılarak yapılmış ve çok değişkenli analizler Cox regresyonu kullanılarak gerçekleştirilmiştir. Bulgular: Toplam 67 hasta değerlendirildi. Hastaların ortanca genel sağkalımı 19,3 aydı [%95 güven aralığı (GA) 15,1 ila ulaşılamadı (NR)]. Toplam 60 hastaya (%89,1) adjuvan tedavi uygulandı. Ortanca genel sağkalım ilk dört hafta içinde tedavi edilen hastalar için 31,1 ay (%95 GA ila 19,3-NR), dört ila altı hafta içinde tedavi edilenler için 15,7 ay (%95 GA ila 15,1-NR) ve altı haftadan sonra tedavi edilenler için 11,3 ay (%95 GA ila 9,8-NR) idi. Sonuç: Çalışmamızda gözlenen sağkalım oranı klinik çalışmalarda bildirilenlerle karşılaştırılabilir düzeydedir. Ancak, daha geç dönemde tedavi alan hastalarda sağkalım oranı anlamlı derecede düşüktü. Bu nedenle, kılavuzların GBM hastalarında adjuvan tedavinin zamanlamasını daha doğru bir şekilde yansıtmasını sağlamak için daha geniş hasta popülasyonlarıyla daha fazla çalışma yapılması önerilmektedir.

Keywords

• : Glioblastoma multiforme
• stupp protokolü
• genel sağkalım
• tedaviye kadar geçen süre

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