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Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma

Yıl 2023, Cilt: 49 Sayı: 1, 63 - 70, 09.06.2023
https://doi.org/10.32708/uutfd.1232437

Öz

Glioblastoma Multiforme (GBM) tanılı olgularımızda sağkalım ve prognostik faktörleri değerlendirmeyi amaçladık. 2015-2020 arasında ortanca 5980 cGy (3400-6090) radyoterapi (RT) ile tedavi edilmiş 69 olgu, Ağustos 2021’de değerlendirildi. Ortanca izlem 12 ay (2-68) ve ortanca yaş 60 (39-77) idi. Total eksizyon, subtotal eksizyon ve biyopsi sırasıyla, %81, %15 ve %4 hastaya uygulanmıştı. RT ile eşzamanlı veya eşzamanlı ve adjuvan veya adjuvan temozolomid (TMZ), sırasıyla %10, %72 ve %9 olguya uygulandı. RT sonrası ilk değerlendirmede %89 (56/63) lokal kontrol, %11 progresyon (7/63) bulundu. Nörolojik düzelme %26 (10/38) olguda gözlendi. Nüks ortanca 7 ayda (3-46) %80 (50/62) olguda gözlenmiş olup son kontrolde olguların %85’si progrese idi (55/66). Tüm olgular için ortanca ve 2 yıllık genel sağkalım (GSK), 12 ay (3-69) ve %17 iken, hastalıksız sağkalım (HSK) sırasıyla, 7 ay (3-55) ve %9 bulundu. Univaryat analizde konvansiyonel RT ve eşzamanlı TMZ alanlarda, sadece RT alanlara göre ortanca GSK (18 vs 5 ay, p < 0.005) ve HSK (13 vs 5 ay, p < 0.002) daha iyi bulundu. Multivaryat analizde GSK için RT sonrası Karnofsky performans skoru ≥ 80 olması, adjuvan TMZ ≥ 5 kür almak, RT dozu ≥ 40 Gy anlamlı bulundu (p < 0,05). Stupp ve arkadaşları, randomize çalışma ile konvansiyonel 60 Gy RT, eşzamanlı ve adjuvan TMZ alanlarda tek başına RT alanlara göre 2 yıl GSK’da anlamlı artış (%27 vs %11) bildirmiştir. İyi prognostik faktörleri olan GBM’li hastalarda, konvansiyonel 60 Gy RT ile eşzamanlı ve adjuvan TMZ, standart tedavi yaklaşımı olup çalışmamızda bu olgularda 2 yıllık GSK %25 oranında elde edilmiştir.

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

Bu çalışmanın istatistiki analizi, Bursa Uludağ Üniversitesi, Tıp Fakültesi, Biyoistatistik AD öğretim üyesi, Doç. Dr Gökhan Ocakoğlu tarafınca gerçekleştirilmiştir.

Kaynakça

  • 1. Sharma A, Graber JJ. Overview of prognostic factors in adult gliomas. Ann Palliat Med, 2021, 10 (1): 863-874.
  • 2. Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Clasisification of tumors of the central nervous system: a summary. Acta Neuropathol, 2016, 131 (6): 803-20.
  • 3. Le Rhun E, Preusser M, Roth P, et al. Molecular targeted therapy of glioblastoma. Cancer Treat Rev, 2019, 80: 101896.
  • 4. Trifiletti DM, Alonso C, Grover S, et al. Prognostic implications of extent of resection in glioblastoma: analysis from a large database. World Neurosurg, 2017, 103: 330-340.
  • 5. Press RH, Shafer SL, Jiang R, et al. Optimal timing of chemoradiotherapy after surgical resection of glioblastoma: stratification by validated prognostic classification. Cancer 2020, 126 (14): 3255-3264.
  • 6. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med, 2005, 352 (10): 987-96.
  • 7. Perry JR, Laperriere N, O’Callaghan CJ, et al. Short-course radiation plus temozolomide in elderly patients with glioblastoma. N Eng J Med, 2017, 376 (11): 1027-1037.
  • 8. Hegi ME, Diserens AC, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med, 2005, 352: 997-1003.
  • 9. Ostrom QT, Gittleman H, Truitt G, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011-2015. Neuro Oncol. 2018, 20 (suppl 4): iv1-iv86.
  • 10. Lacroix M, Abi-Said D, Fourney DR, et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg, 2001, 95 (2): 190-8.
  • 11. Walker MD, Strike TA, Sheline GE. An analysis of dose-effect relationship in the radiotherapy of malignant gliomas. Int J Radiat Oncol Biol Phys, 1979, 5 (10): 1725-31.
  • 12. Chan JL, Lee SW, Fraass BA, et al. Survival and failure patterns of high-grade gliomas after three-dimentional confromal radiotherapy.J Clin Oncol, 2002, 20 (6): 1635-42.
  • 13. Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase II study: 5-yar analyisi of the EORTC-NCIC trial. Lancet Oncol, 2009, 10 (5): 459-66.
  • 14. Zhao Y, Wu J, Shi L. Adjuvant temozolomide fort he treatment of glioblastoma: a meta-analyis of randomized controlled studies. Clin Neuropharmacol, 2021, 44 (4): 132-137.
  • 15. Blumenthal DT, Gorlia T, Gilbert MR, et al. Is more better? The impact of extended adjuvant temozolomide in newly diagnosed glioblastoma: a secondary analysis of EORTC and NRG Oncology/RTOG. Neuro Oncol, 2017, 19 (8): 1119-1126.
  • 16. Curran WJ, Scott CB, Horton J, et al. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst, 1993, 85 (9): 704-10.
  • 17. Mirimanoff RO, Gorlia T, Mason W, et al. Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 26981/22981-NCIC CE3 phase III randomized trial. J Clin Oncol, 24 (16): 2563-9.
  • 18. Johnson DR, Glenn CA, Javan R, Olson JJ. Congress of Neurological Surgeons systematic review and evidence-based guidelines update on the role of imaging in the management of progressive glioblastoma in adults. J Neurooncol, 2022, 158 (2): 139-165.
  • 19. Wen PY, Weller M, Lee EQ, et al. Glioblastoma in adults: a Society for Neuro-Oncology (SNO) and Eurepean Society of neuro-Oncology (EANO) consensus review on current management and future directions. Neuro Oncol, 2020, 22 (8): 1073-1113.
  • 20. Rusthoven KE, Olsen C, Franklin W, et al. Favorable prognosis in patients with high-grade glioma with radiation necrosis: the University of Colorado reoperation series. Int J Radiat Biol Phys, 2011, 81 (1): 211-7.
  • 21. Gorlia T, van den Bent MJ, Hegi ME, et al. Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factorr analysis of EORTC and NCIC 26981-22981/CE3. Lancet Oncol, 2008, 9 (1): 29-38.
  • 22. Cheng H-B, Yue W, Xie C, et al. IDH1 mutation is associated with improved overall survival in patients with glioblastoma: a meta-analysis. Tumor Biology. 2013; 34: 3555-9.
  • 23. Bell EH; Pugh SL, McElroy JP, et al. Molecular-based recursive partitioning analysis model for glioblastoma in the temozolomide era: a correlative analysis based on RG Oncology RTOG 0525. JAMA Oncol, 2017, 3 (6): 784-792.
  • 24. Keime-Guibert F, Chinot O, Taillandier L, et al. Radiotherapy for glioblastoma in the elderly. N eng J Med, 2007, 356 (15): 1527-35.
  • 25. Zorman MJ, Webb P, Nixon M, et al. Surgical and oncological score to estimöate the survival benefit of resection and chemoradiotherapy in elderly (≥ 70 years) glioblastoma patients: a preliminary analysis. Neurooncol Adv, 2022, 4 (1): vdac007.
  • 26. Roa W, Brasher PMA, Bauman G, et al. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol, 2004, 22 (9): 1583-8.
  • 27. Malmstrom A, Gronberg BH, Marosi C, et al. Temozolomide versus standart 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): 916-26.
  • 28. Roa W, Kepka L, Kumar N, et al. International atomic energy agency randomized phase III study of radiation therapy in elderly and/or frail patients eith newly diagnosed glioblastoma multiforme. J Clin Oncol, 2015, 33 (35): 4145-50.
  • 29. Wick W, Platten M, Meisner C, et al. Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly. The NOA-08 randomised phase 3 trial. Lancet Oncol, 13 (7): 707-15.
  • 30. Perlow HK, Prasad RN, Yang M, et al. Accelerated hypofractionated radiation for elderly or frail patients with a newly diagnosed glioblastoma: A pooled analyis of patient-level data from 4 prospective trials. Cancer 2022, 128 (12): 2367-2374.
  • 31. Akiyama Y, Kimura Y, Enatsu R, et al. Advantages and disasvantages of combined chemotherapy with carmustine wafer anf bevacizumab in patients with newly diagnosed glioblastoma: a single-institutional experience. World Neurosurg, 2018, 113: e508-e514.
  • 32. Rominiyi O, Vanderlinden A, Clenton SJ, et al. Tumor treating fields therapy for glioblastoma: current advances and future directions. Br J Cancer, 2021, 124 (4): 697-709.
  • 33. Stupp R, Taillibert S, Kanner A, et al. Effect of Tumor-Treating Fields plus maintenance temozolomide vs maintenance temozolomide alone on survival in patients with glioblastoma: a randomized clinical trial.JAMA; 318 (23): 2306-2316.
  • 34. Wallner KE, Galicich JH, Krol G, et al. Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma. Int J Radiat Oncol Biol Phys, 1989, 16 (6): 1405-9.
  • 35. Niyazi M, Siefert A, Schwarz SB, et al. Therapeutic options for recurrent malignnat glioma. Radiother Oncol, 2011, 98 (1): 1-14.
  • 36. Patel M, Au K, Easaw JC, et al. Repeat resection in recurrent glioblastoma (3rGBM) trial: a randomized care trial. Neurochirurgie, 2022, 68 (3): 262-266.
  • 37. Bunevicius A, Sheehan JP. Radiosurgery for glioblastoma. Neurosurg Clin N Am, 2021, 32 (1): 117-128.
  • 38. Tsien C, Pugh S, Dicker AP, et al. Randomized phase II trial of re-irradiation and concurrent bevacizumab versus bevacizumab alone as treatment for recurrent glioblastoma (NRG Oncology/RTOG 1205): initial outcomes and RT plan quality report. Int J Radiat Biol Phys, 2019, 105 (1) Supplement, S78, 2019, doi: https://doi.org/10.1016/j.ijrobp.2019.06.539.
  • 39. Li X, Jia Z, Yan Y. Efficacy and safety of tumor-treating fields in recurrent glioblastoma: a systematic review and meta-analysis. Acta Neurochir (Wien), 2022, 164 (8): 1985-1993.

Evaluation of Survival and Prognostic Factors in Our Glioblastoma Multiforme Patients: Retrospective Study

Yıl 2023, Cilt: 49 Sayı: 1, 63 - 70, 09.06.2023
https://doi.org/10.32708/uutfd.1232437

Öz

We aimed to evaluate survival and prognostic factors in our cases diagnosed with Glioblastoma Multiforme (GBM). 69 cases treated with a median of 5980 cGy (3400-6090) radiotherapy (RT) between 2015 and 2020 were evaluated on August, 2021. The median follow-up was 12 months (2-68), and median age was 60 (39-77). Total excision, subtotal excision and biopsy were performed in 81%, 15% and 4% of patients, respectively. Concomitant or concomitant and adjuvant or adjuvant temozolomide (TMZ) was administered to 10% and 72% and 9% of cases, respectively. In the first evaluation after RT, there was 89% (56/63) local control and 11% progression (7/63). Neurological improvement was observed in 26% (10/38) of cases. Relapse was observed in a median of 7 months (3-46) in 80% of cases (50/62) and 85% of cases (55/66) were progressed at the last control. The median and 2-year overall survival (OS) was 12 months (3-69), and 17%, while for disease-free survival (DFS) was 7 months (3-55), and 9%, respectively, for all cases. The median OS (18 vs 5 months, p < 0.005) and DFS (13 vs 5 months, p= 0.022) were found better in those who received conventional RT and concomitant TMZ than those who received RT alone in univariate analysis. In the multivariate analysis, Karnofsky performance score ≥ 80 after RT, ≥ 5 courses of adjuvant TMZ, and RT dose ≥ 40 Gy were found significant for OS (p < 0.05). In a randomized study, 2-year OS was reported as 27% (vs 11%) in those who received conventional 60 Gy RT and concomitant TMZ compared RT alone. Conventional 60 Gy RT with concurrent and adjuvant TMZ is the standard treatment approach in patients with GBM who have good prognostic factors, and in our study, 2-year OS was obtained in 25% of these cases.

Proje Numarası

yok

Kaynakça

  • 1. Sharma A, Graber JJ. Overview of prognostic factors in adult gliomas. Ann Palliat Med, 2021, 10 (1): 863-874.
  • 2. Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Clasisification of tumors of the central nervous system: a summary. Acta Neuropathol, 2016, 131 (6): 803-20.
  • 3. Le Rhun E, Preusser M, Roth P, et al. Molecular targeted therapy of glioblastoma. Cancer Treat Rev, 2019, 80: 101896.
  • 4. Trifiletti DM, Alonso C, Grover S, et al. Prognostic implications of extent of resection in glioblastoma: analysis from a large database. World Neurosurg, 2017, 103: 330-340.
  • 5. Press RH, Shafer SL, Jiang R, et al. Optimal timing of chemoradiotherapy after surgical resection of glioblastoma: stratification by validated prognostic classification. Cancer 2020, 126 (14): 3255-3264.
  • 6. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med, 2005, 352 (10): 987-96.
  • 7. Perry JR, Laperriere N, O’Callaghan CJ, et al. Short-course radiation plus temozolomide in elderly patients with glioblastoma. N Eng J Med, 2017, 376 (11): 1027-1037.
  • 8. Hegi ME, Diserens AC, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med, 2005, 352: 997-1003.
  • 9. Ostrom QT, Gittleman H, Truitt G, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011-2015. Neuro Oncol. 2018, 20 (suppl 4): iv1-iv86.
  • 10. Lacroix M, Abi-Said D, Fourney DR, et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg, 2001, 95 (2): 190-8.
  • 11. Walker MD, Strike TA, Sheline GE. An analysis of dose-effect relationship in the radiotherapy of malignant gliomas. Int J Radiat Oncol Biol Phys, 1979, 5 (10): 1725-31.
  • 12. Chan JL, Lee SW, Fraass BA, et al. Survival and failure patterns of high-grade gliomas after three-dimentional confromal radiotherapy.J Clin Oncol, 2002, 20 (6): 1635-42.
  • 13. Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase II study: 5-yar analyisi of the EORTC-NCIC trial. Lancet Oncol, 2009, 10 (5): 459-66.
  • 14. Zhao Y, Wu J, Shi L. Adjuvant temozolomide fort he treatment of glioblastoma: a meta-analyis of randomized controlled studies. Clin Neuropharmacol, 2021, 44 (4): 132-137.
  • 15. Blumenthal DT, Gorlia T, Gilbert MR, et al. Is more better? The impact of extended adjuvant temozolomide in newly diagnosed glioblastoma: a secondary analysis of EORTC and NRG Oncology/RTOG. Neuro Oncol, 2017, 19 (8): 1119-1126.
  • 16. Curran WJ, Scott CB, Horton J, et al. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst, 1993, 85 (9): 704-10.
  • 17. Mirimanoff RO, Gorlia T, Mason W, et al. Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 26981/22981-NCIC CE3 phase III randomized trial. J Clin Oncol, 24 (16): 2563-9.
  • 18. Johnson DR, Glenn CA, Javan R, Olson JJ. Congress of Neurological Surgeons systematic review and evidence-based guidelines update on the role of imaging in the management of progressive glioblastoma in adults. J Neurooncol, 2022, 158 (2): 139-165.
  • 19. Wen PY, Weller M, Lee EQ, et al. Glioblastoma in adults: a Society for Neuro-Oncology (SNO) and Eurepean Society of neuro-Oncology (EANO) consensus review on current management and future directions. Neuro Oncol, 2020, 22 (8): 1073-1113.
  • 20. Rusthoven KE, Olsen C, Franklin W, et al. Favorable prognosis in patients with high-grade glioma with radiation necrosis: the University of Colorado reoperation series. Int J Radiat Biol Phys, 2011, 81 (1): 211-7.
  • 21. Gorlia T, van den Bent MJ, Hegi ME, et al. Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factorr analysis of EORTC and NCIC 26981-22981/CE3. Lancet Oncol, 2008, 9 (1): 29-38.
  • 22. Cheng H-B, Yue W, Xie C, et al. IDH1 mutation is associated with improved overall survival in patients with glioblastoma: a meta-analysis. Tumor Biology. 2013; 34: 3555-9.
  • 23. Bell EH; Pugh SL, McElroy JP, et al. Molecular-based recursive partitioning analysis model for glioblastoma in the temozolomide era: a correlative analysis based on RG Oncology RTOG 0525. JAMA Oncol, 2017, 3 (6): 784-792.
  • 24. Keime-Guibert F, Chinot O, Taillandier L, et al. Radiotherapy for glioblastoma in the elderly. N eng J Med, 2007, 356 (15): 1527-35.
  • 25. Zorman MJ, Webb P, Nixon M, et al. Surgical and oncological score to estimöate the survival benefit of resection and chemoradiotherapy in elderly (≥ 70 years) glioblastoma patients: a preliminary analysis. Neurooncol Adv, 2022, 4 (1): vdac007.
  • 26. Roa W, Brasher PMA, Bauman G, et al. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol, 2004, 22 (9): 1583-8.
  • 27. Malmstrom A, Gronberg BH, Marosi C, et al. Temozolomide versus standart 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): 916-26.
  • 28. Roa W, Kepka L, Kumar N, et al. International atomic energy agency randomized phase III study of radiation therapy in elderly and/or frail patients eith newly diagnosed glioblastoma multiforme. J Clin Oncol, 2015, 33 (35): 4145-50.
  • 29. Wick W, Platten M, Meisner C, et al. Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly. The NOA-08 randomised phase 3 trial. Lancet Oncol, 13 (7): 707-15.
  • 30. Perlow HK, Prasad RN, Yang M, et al. Accelerated hypofractionated radiation for elderly or frail patients with a newly diagnosed glioblastoma: A pooled analyis of patient-level data from 4 prospective trials. Cancer 2022, 128 (12): 2367-2374.
  • 31. Akiyama Y, Kimura Y, Enatsu R, et al. Advantages and disasvantages of combined chemotherapy with carmustine wafer anf bevacizumab in patients with newly diagnosed glioblastoma: a single-institutional experience. World Neurosurg, 2018, 113: e508-e514.
  • 32. Rominiyi O, Vanderlinden A, Clenton SJ, et al. Tumor treating fields therapy for glioblastoma: current advances and future directions. Br J Cancer, 2021, 124 (4): 697-709.
  • 33. Stupp R, Taillibert S, Kanner A, et al. Effect of Tumor-Treating Fields plus maintenance temozolomide vs maintenance temozolomide alone on survival in patients with glioblastoma: a randomized clinical trial.JAMA; 318 (23): 2306-2316.
  • 34. Wallner KE, Galicich JH, Krol G, et al. Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma. Int J Radiat Oncol Biol Phys, 1989, 16 (6): 1405-9.
  • 35. Niyazi M, Siefert A, Schwarz SB, et al. Therapeutic options for recurrent malignnat glioma. Radiother Oncol, 2011, 98 (1): 1-14.
  • 36. Patel M, Au K, Easaw JC, et al. Repeat resection in recurrent glioblastoma (3rGBM) trial: a randomized care trial. Neurochirurgie, 2022, 68 (3): 262-266.
  • 37. Bunevicius A, Sheehan JP. Radiosurgery for glioblastoma. Neurosurg Clin N Am, 2021, 32 (1): 117-128.
  • 38. Tsien C, Pugh S, Dicker AP, et al. Randomized phase II trial of re-irradiation and concurrent bevacizumab versus bevacizumab alone as treatment for recurrent glioblastoma (NRG Oncology/RTOG 1205): initial outcomes and RT plan quality report. Int J Radiat Biol Phys, 2019, 105 (1) Supplement, S78, 2019, doi: https://doi.org/10.1016/j.ijrobp.2019.06.539.
  • 39. Li X, Jia Z, Yan Y. Efficacy and safety of tumor-treating fields in recurrent glioblastoma: a systematic review and meta-analysis. Acta Neurochir (Wien), 2022, 164 (8): 1985-1993.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Onkoloji ve Karsinogenez, Sinirbilim
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Süreyya Sarıhan 0000-0003-4816-5798

Gürkan Gurbay Aslan Bu kişi benim 0000-0003-1441-3394

Türkkan Evrensel Bu kişi benim 0000-0002-9732-5340

Hasan Kocaeli Bu kişi benim 0000-0003-4140-5955

Proje Numarası yok
Yayımlanma Tarihi 9 Haziran 2023
Kabul Tarihi 16 Mart 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 49 Sayı: 1

Kaynak Göster

APA Sarıhan, S., Aslan, G. G., Evrensel, T., Kocaeli, H. (2023). Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 49(1), 63-70. https://doi.org/10.32708/uutfd.1232437
AMA Sarıhan S, Aslan GG, Evrensel T, Kocaeli H. Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma. Uludağ Tıp Derg. Haziran 2023;49(1):63-70. doi:10.32708/uutfd.1232437
Chicago Sarıhan, Süreyya, Gürkan Gurbay Aslan, Türkkan Evrensel, ve Hasan Kocaeli. “Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım Ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 49, sy. 1 (Haziran 2023): 63-70. https://doi.org/10.32708/uutfd.1232437.
EndNote Sarıhan S, Aslan GG, Evrensel T, Kocaeli H (01 Haziran 2023) Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma. Uludağ Üniversitesi Tıp Fakültesi Dergisi 49 1 63–70.
IEEE S. Sarıhan, G. G. Aslan, T. Evrensel, ve H. Kocaeli, “Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma”, Uludağ Tıp Derg, c. 49, sy. 1, ss. 63–70, 2023, doi: 10.32708/uutfd.1232437.
ISNAD Sarıhan, Süreyya vd. “Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım Ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 49/1 (Haziran 2023), 63-70. https://doi.org/10.32708/uutfd.1232437.
JAMA Sarıhan S, Aslan GG, Evrensel T, Kocaeli H. Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma. Uludağ Tıp Derg. 2023;49:63–70.
MLA Sarıhan, Süreyya vd. “Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım Ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 49, sy. 1, 2023, ss. 63-70, doi:10.32708/uutfd.1232437.
Vancouver Sarıhan S, Aslan GG, Evrensel T, Kocaeli H. Glioblastoma Multiforme Tanılı Olgularımızda Sağkalım ve Prognostik Faktörlerin Değerlendirilmesi: Retrospektif Çalışma. Uludağ Tıp Derg. 2023;49(1):63-70.

ISSN: 1300-414X, e-ISSN: 2645-9027

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2023