Email updates

Keep up to date with the latest news and content from BMC Cancer and BioMed Central.

Open Access Research article

Clinical variables serve as prognostic factors in a model for survival from glioblastoma multiforme: an observational study of a cohort of consecutive non-selected patients from a single institution

Signe Regner Michaelsen1, Ib Jarle Christensen2, Kirsten Grunnet1, Marie-Thérése Stockhausen1, Helle Broholm3, Michael Kosteljanetz4 and Hans Skovgaard Poulsen1*

Author Affiliations

1 Department of Radiation Biology, The Finsen Center, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark

2 The Finsen Laboratory, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen and Biotech Research and Innovation Center (BRIC), University of Copenhagen, Ole Maaløes Vej 5, DK-2200 Copenhagen, Denmark

3 Department of Neuropathology, Center of Diagnostic Investigation, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark

4 Department of Neurosurgery, The Neurocenter, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark

For all author emails, please log on.

BMC Cancer 2013, 13:402  doi:10.1186/1471-2407-13-402

Published: 3 September 2013

Abstract

Background

Although implementation of temozolomide (TMZ) as a part of primary therapy for glioblastoma multiforme (GBM) has resulted in improved patient survival, the disease is still incurable. Previous studies have correlated various parameters to survival, although no single parameter has yet been identified. More studies and new approaches to identify the best and worst performing patients are therefore in great demand.

Methods

This study examined 225 consecutive, non-selected GBM patients with performance status (PS) 0–2 receiving postoperative radiotherapy with concomitant and adjuvant TMZ as primary therapy. At relapse, patients with PS 0–2 were mostly treated by reoperation and/or combination with bevacizumab/irinotecan (BEV/IRI), while a few received TMZ therapy if the recurrence-free period was >6 months.

Results

Median overall survival and time to progression were 14.3 and 8.0 months, respectively. Second-line therapy indicated that reoperation and/or BEV/IRI increased patient survival compared with untreated patients and that BEV/IRI was more effective than reoperation alone. Patient age, ECOG PS, and use of corticosteroid therapy were significantly correlated with patient survival and disease progression on univariate analysis, whereas p53, epidermal growth factor receptor, and O6-methylguanine-DNA methyltransferase expression (all detected by immunohistochemistry), tumor size or multifocality, and extent of primary operation were not. A model based on age, ECOG PS, and corticosteroids use was able to predict survival probability for an individual patient.

Conclusion

The survival of RT/TMZ-treated GBM patients can be predicted based on patient age, ECOG PS, and corticosteroid therapy status.

Keywords:
Bevacizumab; Glioblastoma multiforme; Prognosis; Temozolomide