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Treatment Outcomes of Glioblastoma Multiforme at Community Based Teaching Hospital

Posted on: 05/15/2008

Treatment Outcomes of Glioblastoma Multiforme at Community Based Teaching Hospital

A.N. Joshi , C. P. Chahal, J. Landolfi, New Jersey Neuroscience Institute @ JFK Medical Center, Edison, NJ and Seton Hall University School of Graduate Medical Education, South Orange, NJ

Introduction: Glioblastoma Multiforme (GBM) is the most frequent primary malignant brain tumor in adults. The standard management consists of surgical resection to the extent that is safely feasible, followed by radiotherapy with concomitant and adjuvant temozolomide. At recurrence, the patient may be treated with one or a combination of treatments which can include re-resection, chemotherapy and in some subcentimeter lesions, radiosurgery. This study was conducted to access treatment outcomes, to compare it to current trends and to establish a baseline for future trends.

Methods: We conducted a retrospective study to determine the overall survival rate of 49 patients who were diagnosed with GBM and treated at JFK medical center between 2003 and 2007. Data was obtained from the hospitals brain tumor registry, inpatient/outpatient records, pathology reports, as well as radiotherapy records.

Results: The study sample was comprised of 27 males (55%) and 22 females (45%). The median age at diagnosis was 61 years (median age 61years; range 31-80 years); 24% were < 50 years. 70% of patients were white, 4% were African Americans, and 26% were other races.  4% of patients had a KPS score of 0 to 40, 39% a KPS score of 51 to 70 and 57% a KPS score of 71 to 100. 84% patients underwent surgical resection either gross total, subtotal or partial with or without chemotherapeutic wafer placement, and 16% underwent biopsy alone. Four patients were lost to follow up with our institution. Overall survival rate was 51% (n=23) at 1 year, 22% (n=10) at 2 years and median survival was 16.9 months (95% CI, 12.6%-21.1%).

A multi center Phase III trial by Stupp et al. reported a 2 year survival rate of 26.5% and a median survival of 14.6 months in patients who received radiotherapy plus concomitant and adjuvant temozolomide. Our study indicates that 2 year survival rates in GBM patients treated at Community-based teaching hospital with a Neuro-oncologist on staff are similar to the national survival rates.

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