Influence of Oncotherapy and Clinical Parameters on Survival of Glioblastoma Patients: A Single Center Experience
Background: Routine administration of temozolomide (TMZ) in the treatment protocol of glioblastoma in the last few years resulted in improving survival parameters of these patients but efficacy of supplementary bevacizumab (BVC) monotherapy has not been evidently proven. In this study, the effective...
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| Veröffentlicht in: | Neurology India 2019-07, Vol.67 (4), p.1066-1073 |
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| creator | Klekner, Almos Tóth, Judit Virga, József Hortobágyi, Tibor Dér, Ádám Szemcsák, Csaba Reményi-Puskár, Judit Bognár, László |
| description | Background: Routine administration of temozolomide (TMZ) in the treatment protocol of glioblastoma in the last few years resulted in improving survival parameters of these patients but efficacy of supplementary bevacizumab (BVC) monotherapy has not been evidently proven. In this study, the effectiveness of different postoperative therapy for glioblastoma patients treated in our institute was evaluated. In addition, the prognostic value of clinical parameters on survival was also analyzed.
Methods: Accordance of clinical parameters (age, gender, tumor localization, size, side, Karnofsky performance score, and extension of tumor removal), postoperative treatment (radiotherapy [RT], RT + TMZ, RT + TMZ + BVC), and survival data were tested by 104 patients operated on glioblastoma in the Department of Neurosurgery, University of Debrecen between 2002 and 2012.
Results: Concurrent chemo-RT resulted in significant longer overall survival (OS) than RT alone (PRTvs.RT + TMZ = 0.0219) and BVC treatment after progression during TMZ also elongated survival significantly (PRT vs. RT + TMZ + BVC < 0.0001; PRT + TMZvs.RT + TMZ + BVC = 0.0022), respectively. Clinical parameters showed no significant influence on OS in comparison with different methods of postoperative oncotherapy.
Conclusions: Both TMZ and BVC had a beneficial effect on glioblastoma patients' survival, but tested clinical parameters showed no evident accordance with final outcome. Although neurosurgery has an indispensable role in resecting space occupying tumors and providing good postoperative performance score patients for oncotherapy, the survival of glioblastoma patients depends rather on radio- and chemo-sensitivity than tested clinical parameters. |
| doi_str_mv | 10.4103/0028-3886.266257 |
| format | Article |
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Methods: Accordance of clinical parameters (age, gender, tumor localization, size, side, Karnofsky performance score, and extension of tumor removal), postoperative treatment (radiotherapy [RT], RT + TMZ, RT + TMZ + BVC), and survival data were tested by 104 patients operated on glioblastoma in the Department of Neurosurgery, University of Debrecen between 2002 and 2012.
Results: Concurrent chemo-RT resulted in significant longer overall survival (OS) than RT alone (PRTvs.RT + TMZ = 0.0219) and BVC treatment after progression during TMZ also elongated survival significantly (PRT vs. RT + TMZ + BVC < 0.0001; PRT + TMZvs.RT + TMZ + BVC = 0.0022), respectively. Clinical parameters showed no significant influence on OS in comparison with different methods of postoperative oncotherapy.
Conclusions: Both TMZ and BVC had a beneficial effect on glioblastoma patients' survival, but tested clinical parameters showed no evident accordance with final outcome. Although neurosurgery has an indispensable role in resecting space occupying tumors and providing good postoperative performance score patients for oncotherapy, the survival of glioblastoma patients depends rather on radio- and chemo-sensitivity than tested clinical parameters.</description><identifier>ISSN: 0028-3886</identifier><identifier>EISSN: 1998-4022</identifier><identifier>DOI: 10.4103/0028-3886.266257</identifier><identifier>PMID: 31512637</identifier><language>eng</language><publisher>India: Wolters Kluwer India Pvt. Ltd</publisher><subject>Adult ; Age ; Aged ; Antineoplastic Agents - pharmacology ; Bevacizumab ; Bevacizumab - pharmacology ; Brain cancer ; Brain Neoplasms - mortality ; Brain Neoplasms - therapy ; Chemotherapy ; Dosage and administration ; Drug therapy ; Family medical history ; Female ; Gender ; Glioblastoma - mortality ; Glioblastoma - therapy ; Glioblastomas ; Gliomas ; Humans ; Immunotherapy ; Localization ; Male ; Medical prognosis ; Medical research ; Middle Aged ; Monoclonal antibodies ; Neurosurgery ; Neurosurgical Procedures - statistics & numerical data ; NMR ; Nuclear magnetic resonance ; Outcome Assessment, Health Care - statistics & numerical data ; Patients ; Progression-Free Survival ; Radiotherapy - statistics & numerical data ; Statistical analysis ; Surgery ; Survival Analysis ; Targeted cancer therapy ; Temozolomide - pharmacology ; Tumors</subject><ispartof>Neurology India, 2019-07, Vol.67 (4), p.1066-1073</ispartof><rights>COPYRIGHT 2019 Medknow Publications and Media Pvt. Ltd.</rights><rights>2019. This work is published under https://creativecommons.org/licenses/by-nc-sa/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c492c-abb10f156dd6f23e4ee0dd4e76b221f328b50119cc30f140576eb8e727ad65cd3</citedby><cites>FETCH-LOGICAL-c492c-abb10f156dd6f23e4ee0dd4e76b221f328b50119cc30f140576eb8e727ad65cd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31512637$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Klekner, Almos</creatorcontrib><creatorcontrib>Tóth, Judit</creatorcontrib><creatorcontrib>Virga, József</creatorcontrib><creatorcontrib>Hortobágyi, Tibor</creatorcontrib><creatorcontrib>Dér, Ádám</creatorcontrib><creatorcontrib>Szemcsák, Csaba</creatorcontrib><creatorcontrib>Reményi-Puskár, Judit</creatorcontrib><creatorcontrib>Bognár, László</creatorcontrib><title>Influence of Oncotherapy and Clinical Parameters on Survival of Glioblastoma Patients: A Single Center Experience</title><title>Neurology India</title><addtitle>Neurol India</addtitle><description>Background: Routine administration of temozolomide (TMZ) in the treatment protocol of glioblastoma in the last few years resulted in improving survival parameters of these patients but efficacy of supplementary bevacizumab (BVC) monotherapy has not been evidently proven. In this study, the effectiveness of different postoperative therapy for glioblastoma patients treated in our institute was evaluated. In addition, the prognostic value of clinical parameters on survival was also analyzed.
Methods: Accordance of clinical parameters (age, gender, tumor localization, size, side, Karnofsky performance score, and extension of tumor removal), postoperative treatment (radiotherapy [RT], RT + TMZ, RT + TMZ + BVC), and survival data were tested by 104 patients operated on glioblastoma in the Department of Neurosurgery, University of Debrecen between 2002 and 2012.
Results: Concurrent chemo-RT resulted in significant longer overall survival (OS) than RT alone (PRTvs.RT + TMZ = 0.0219) and BVC treatment after progression during TMZ also elongated survival significantly (PRT vs. RT + TMZ + BVC < 0.0001; PRT + TMZvs.RT + TMZ + BVC = 0.0022), respectively. Clinical parameters showed no significant influence on OS in comparison with different methods of postoperative oncotherapy.
Conclusions: Both TMZ and BVC had a beneficial effect on glioblastoma patients' survival, but tested clinical parameters showed no evident accordance with final outcome. Although neurosurgery has an indispensable role in resecting space occupying tumors and providing good postoperative performance score patients for oncotherapy, the survival of glioblastoma patients depends rather on radio- and chemo-sensitivity than tested clinical parameters.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Antineoplastic Agents - pharmacology</subject><subject>Bevacizumab</subject><subject>Bevacizumab - pharmacology</subject><subject>Brain cancer</subject><subject>Brain Neoplasms - mortality</subject><subject>Brain Neoplasms - therapy</subject><subject>Chemotherapy</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Family medical history</subject><subject>Female</subject><subject>Gender</subject><subject>Glioblastoma - mortality</subject><subject>Glioblastoma - therapy</subject><subject>Glioblastomas</subject><subject>Gliomas</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Localization</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Neurosurgery</subject><subject>Neurosurgical Procedures - statistics & numerical data</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Outcome Assessment, Health Care - statistics & numerical data</subject><subject>Patients</subject><subject>Progression-Free Survival</subject><subject>Radiotherapy - statistics & numerical data</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Targeted cancer therapy</subject><subject>Temozolomide - pharmacology</subject><subject>Tumors</subject><issn>0028-3886</issn><issn>1998-4022</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkk1v1DAQhi0EokvhzglZ4pzFH4kTc1tFpVSqVKTC2XKcyeLWsbd20qX_HkfbFiqtfLBm5nlnNH6N0EdK1iUl_AshrCl404g1E4JV9Su0olI2RUkYe41Wz-UT9C6lmxxyTtlbdMJpRZng9QrdXfjBzeAN4DDgK2_C9Bui3j1g7XvcOuut0Q7_0FGPMEFMOHh8Pcd7e5_TWXLubOicTlMYdcYmC35KX_EGX1u_dYDbHEPEZ392EO0y5z16M2iX4MPjfYp-fTv72X4vLq_OL9rNZWFKyUyhu46SgVai78XAOJQApO9LqEXHGB04a7qKUCqN4RkrSVUL6BqoWa17UZmen6LPh767GO5mSJO6CXP0eaRiTBLBZcPkP2qrHSjrhzBFbUabjNpUUtKKl7zJVHGE2oLPT-WCh8Hm9At-fYTPp4fRmqMCchCYGFKKMKhdtKOOD4oStVitFi_V4qU6WJ0lnx73m7sR-mfBk7cZaA_APrjFuVs37yGqzN76sH_RuPivcS4IoZ6-Bf8LS5e3kQ</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Klekner, Almos</creator><creator>Tóth, Judit</creator><creator>Virga, József</creator><creator>Hortobágyi, Tibor</creator><creator>Dér, Ádám</creator><creator>Szemcsák, Csaba</creator><creator>Reményi-Puskár, Judit</creator><creator>Bognár, László</creator><general>Wolters Kluwer India Pvt. 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pharmacology</topic><topic>Bevacizumab</topic><topic>Bevacizumab - pharmacology</topic><topic>Brain cancer</topic><topic>Brain Neoplasms - mortality</topic><topic>Brain Neoplasms - therapy</topic><topic>Chemotherapy</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Family medical history</topic><topic>Female</topic><topic>Gender</topic><topic>Glioblastoma - mortality</topic><topic>Glioblastoma - therapy</topic><topic>Glioblastomas</topic><topic>Gliomas</topic><topic>Humans</topic><topic>Immunotherapy</topic><topic>Localization</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>Neurosurgery</topic><topic>Neurosurgical Procedures - statistics & numerical data</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Outcome Assessment, Health Care - statistics & numerical data</topic><topic>Patients</topic><topic>Progression-Free Survival</topic><topic>Radiotherapy - statistics & numerical data</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Survival Analysis</topic><topic>Targeted cancer therapy</topic><topic>Temozolomide - pharmacology</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klekner, Almos</creatorcontrib><creatorcontrib>Tóth, Judit</creatorcontrib><creatorcontrib>Virga, József</creatorcontrib><creatorcontrib>Hortobágyi, Tibor</creatorcontrib><creatorcontrib>Dér, Ádám</creatorcontrib><creatorcontrib>Szemcsák, Csaba</creatorcontrib><creatorcontrib>Reményi-Puskár, Judit</creatorcontrib><creatorcontrib>Bognár, László</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Neurology India</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Klekner, Almos</au><au>Tóth, Judit</au><au>Virga, József</au><au>Hortobágyi, Tibor</au><au>Dér, Ádám</au><au>Szemcsák, Csaba</au><au>Reményi-Puskár, Judit</au><au>Bognár, László</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of Oncotherapy and Clinical Parameters on Survival of Glioblastoma Patients: A Single Center Experience</atitle><jtitle>Neurology India</jtitle><addtitle>Neurol India</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>67</volume><issue>4</issue><spage>1066</spage><epage>1073</epage><pages>1066-1073</pages><issn>0028-3886</issn><eissn>1998-4022</eissn><abstract>Background: Routine administration of temozolomide (TMZ) in the treatment protocol of glioblastoma in the last few years resulted in improving survival parameters of these patients but efficacy of supplementary bevacizumab (BVC) monotherapy has not been evidently proven. In this study, the effectiveness of different postoperative therapy for glioblastoma patients treated in our institute was evaluated. In addition, the prognostic value of clinical parameters on survival was also analyzed.
Methods: Accordance of clinical parameters (age, gender, tumor localization, size, side, Karnofsky performance score, and extension of tumor removal), postoperative treatment (radiotherapy [RT], RT + TMZ, RT + TMZ + BVC), and survival data were tested by 104 patients operated on glioblastoma in the Department of Neurosurgery, University of Debrecen between 2002 and 2012.
Results: Concurrent chemo-RT resulted in significant longer overall survival (OS) than RT alone (PRTvs.RT + TMZ = 0.0219) and BVC treatment after progression during TMZ also elongated survival significantly (PRT vs. RT + TMZ + BVC < 0.0001; PRT + TMZvs.RT + TMZ + BVC = 0.0022), respectively. Clinical parameters showed no significant influence on OS in comparison with different methods of postoperative oncotherapy.
Conclusions: Both TMZ and BVC had a beneficial effect on glioblastoma patients' survival, but tested clinical parameters showed no evident accordance with final outcome. Although neurosurgery has an indispensable role in resecting space occupying tumors and providing good postoperative performance score patients for oncotherapy, the survival of glioblastoma patients depends rather on radio- and chemo-sensitivity than tested clinical parameters.</abstract><cop>India</cop><pub>Wolters Kluwer India Pvt. Ltd</pub><pmid>31512637</pmid><doi>10.4103/0028-3886.266257</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Neurology India, 2019-07, Vol.67 (4), p.1066-1073 |
| issn | 0028-3886 1998-4022 |
| language | eng |
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| subjects | Adult Age Aged Antineoplastic Agents - pharmacology Bevacizumab Bevacizumab - pharmacology Brain cancer Brain Neoplasms - mortality Brain Neoplasms - therapy Chemotherapy Dosage and administration Drug therapy Family medical history Female Gender Glioblastoma - mortality Glioblastoma - therapy Glioblastomas Gliomas Humans Immunotherapy Localization Male Medical prognosis Medical research Middle Aged Monoclonal antibodies Neurosurgery Neurosurgical Procedures - statistics & numerical data NMR Nuclear magnetic resonance Outcome Assessment, Health Care - statistics & numerical data Patients Progression-Free Survival Radiotherapy - statistics & numerical data Statistical analysis Surgery Survival Analysis Targeted cancer therapy Temozolomide - pharmacology Tumors |
| title | Influence of Oncotherapy and Clinical Parameters on Survival of Glioblastoma Patients: A Single Center Experience |
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