Universität zu Köln

Stavrinou, Pantelis, Kalyvas, Aristotelis, Grau, Stefan, Hamisch, Christina, Galldiks, Norbert ORCID: 0000-0002-2485-1796, Katsigiannis, Sotirios, Kabbasch, Christoph, Timmer, Marco, Goldbrunner, Roland and Stranjalis, George (2019). Survival effects of a strategy favoring second-line multimodal treatment compared to supportive care in glioblastoma patients at first progression. J. Neurosurg., 131 (4). S. 1136 - 1142. ROLLING MEADOWS: AMER ASSOC NEUROLOGICAL SURGEONS. ISSN 1933-0693

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Abstract

OBJECTIVE Data on the survival effects of supportive care compared to second-line multimodal treatment for glioblastoma progression are scarce. Thus, the authors assessed survival in two population-based, similar cohorts from two European university hospitals with different treatment strategies at first progression. METHODS The authors retrospectively identified patients with newly diagnosed glioblastoma treated at two neurooncological centers. After diagnosis, patients from both centers received identical treatments, but at tumor progression each center used a different approach. In the majority of cases, at center A (Greece), supportive care or a single therapeutic modality was offered at progression, whereas center B (Germany) provided multimodal second-line therapy. The main outcome measure was survival after progression (SaP). The influence of the treatment strategy on SaP was assessed by multivariate analysis. RESULTS One hundred three patients from center A and 156 from center B were included. Tumor progression was observed in 86 patients (center A) and 136 patients (center B). At center A, 53 patients (72.6%) received supportive care alone, while at center B, 91 patients (80.5%) received second-line treatment. Progression-free survival at both centers was similar (9.4 months [center A] vs 9.0 months [center B]; p = 0.97), but SaP was significantly improved in the patients treated with multimodal second-line therapy at center B (7 months, 95% CI 5.3-8.7 months) compared to those treated with supportive care or a single therapeutic modality at center A (4.5 months, 95% CI 3.5-5.5 months; p = 0.003). In the multivariate analysis, the treatment center was an independent prognostic factor for overall survival (HR 1.59, 95% CI 0.17-2.15; p = 0.002). CONCLUSIONS Treatment strategy favoring multimodal second-line treatment over minimal treatment or supportive care at glioblastoma progression is associated with significantly better overall survival.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stavrinou, Pantelis UNSPECIFIED UNSPECIFIED UNSPECIFIED Kalyvas, Aristotelis UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamisch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Katsigiannis, Sotirios UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmer, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Stranjalis, George UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-132483
DOI:	10.3171/2018.7.JNS18228
Journal or Publication Title:	J. Neurosurg.
Volume:	131
Number:	4
Page Range:	S. 1136 - 1142
Date:	2019
Publisher:	AMER ASSOC NEUROLOGICAL SURGEONS
Place of Publication:	ROLLING MEADOWS
ISSN:	1933-0693
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RECURRENT GLIOBLASTOMA; ADJUVANT TEMOZOLOMIDE; RADIOTHERAPY; MANAGEMENT; SURGERY; BEVACIZUMAB; CONCOMITANT; RESECTION; GLIOMAS; TIME Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13248