Patterns of care and survival for patients with glioblastoma multiforme diagnosed during 2006

Abstract

Standard treatment for glioblastoma multiforme (GBM) changed in 2005 when addition of temozolomide (TMZ) to maximal surgical resection followed by radiation therapy (RT) was shown to prolong survival in a clinical trial. In this study, we assessed treatment patterns and survival of patients with GBM in community settings in the United States. Patients with newly diagnosed GBM who were aged ≥20 years in 2006 (n = 1202) were identified as part of the National Cancer Institute 's Patterns of Care Studies. We assessed treatment patterns, and in the subset of patients who received total or partial surgical resection, we used multivariable regression analysis to assess patient, clinical, and health system factors associated with receipt of adjuvant chemotherapy and RT and survival through 2008. Approximately 65% of patients with GBM received total or partial surgical resection, and approximately 70% of these patients received adjuvant TMZ and RT. Receipt of adjuvant therapy was associated with patient age, marital status, health insurance, and tumor location. Median survival in all patients was 10 months (95% confidence interval [CI], 9-11 months). Receipt of adjuvant therapy following resection was associated with a lower risk of dying in adjusted analyses for patients who received TMZ and RT (hazard ratio [HR], 0.25; 95% CI, 0.18-0.35) and other adjuvant therapies (HR, 0.55; 95% CI, 0.37-0.81), compared with no adjuvant therapy. We observed rapid diffusion of a new standard of treatment, adjuvant and concurrent TMZ with RT, among adult patients with newly diagnosed GBM in the community setting following publication of a pivotal clinical trial.

Fig. 1.

Receipt of chemotherapy and radiation therapy among patients who received a diagnosis of glioblastoma multiforme in 2006, by type of surgery (N = 1202).

Fig. 2.

Months of survival among patients who received a diagnosis of glioblastoma in 2006, by type of surgery (N = 1082).

Fig. 3.

Months of survival following glioblastoma diagnosis in 2006, among patients with surgical resection and temozolomide and radiation, by type of surgery (N = 562).

Fig. 4.

Months of survival following glioblastoma diagnosis in 2006, by receipt of chemotherapy and radiation among patients with total or partial surgical resection (N = 775).