In: BMC Cancer, 15 (2015), Nr. 558. pp. 1-7. ISSN 1471-2407
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Abstract
Background: The benefits of new innovations in glioblastoma therapies should not be curtailed as a result of delays in commencement of radiation therapy, caused by clinical circumstances as well as diagnostic procedures. This study evaluates whether delays in chemo-radiotherapy after surgery, while determining O6-methylguanine-DNA-methyltransferase (MGMT) promoter status, affect the survival rates of patients with glioblastoma (GBM). Methods: Our sample comprised 50 GBM patients in a retrospective analysis of three prospective studies that focused on combined radiotherapy and required MGMT promoter-status testing as inclusion criteria. Results were compared with a reference group of 127 favourable GBM cases (Karnofsky performance-status scale ≥ 70), in which the patients underwent standard postoperative chemo-radiotherapy with temozolomide. Survival time was calculated using the Kaplan-Meier method, and a multivariate analysis of the delays between surgical and radiotherapy procedures was performed using the Cox regression model. Results: The study group’s median overall survival time was 16.2 months (with a range of 2 to 56 months), versus the reference group’s survival time of 18.2 months (with a range of 1 to 92 months) (p = 0.64). The delay between surgery and radiotherapy was increased by 8 days in the study patients (p < 0.001), with a median delay of 35 days (range: 18–49 days) corresponding to the typical 27-day delay (range: 5–98 days) for those in the reference group. Univariate and multivariate analyses did not show any negative association between survival time and delaying radiation therapy to determine MGMT-promoter status; commencement of radiation therapy sooner than 24 days after surgery was the threshold for significantly decreased overall survival (p = 0.01) and progression-free (p = 0.03) survival. Conclusion: Delaying postoperative chemoradiation for GBM patients—carried out in order to determine MGMT-promoter status—did not have a negative impact on survival time. Indeed, the data of the present study shows that initiating radiation therapy sooner than 24 days after surgery has a negative impact on progression and survival.
Document type: | Article |
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Journal or Publication Title: | BMC Cancer |
Volume: | 15 |
Number: | 558 |
Publisher: | BioMed Central |
Place of Publication: | London |
Date Deposited: | 14 Jan 2016 10:40 |
Date: | 2015 |
ISSN: | 1471-2407 |
Page Range: | pp. 1-7 |
Faculties / Institutes: | Medizinische Fakultät Heidelberg > Neurologische Universitätsklinik Medizinische Fakultät Heidelberg > Radiologische Universitätsklinik Medizinische Fakultät Heidelberg > Heidelberg Ion-Beam Therapy Center (HIT) |
DDC-classification: | 610 Medical sciences Medicine |