Pattern of care and effectiveness of treatment for glioblastoma patients in the real world: Results from a prospective population-based registry. Could survival differ in a high-volume center?

Alba A Brandes¹, Enrico Franceschi¹, Mario Ermani¹, Alicia Tosoni¹, Fiorenzo Albani¹, Roberta Depenni¹, Marina Faedi¹, Anna Pisanello¹, Girolamo Crisi¹, Benedetta Urbini¹, Claudio Dazzi¹, Luigi Cavanna¹, Claudia Mucciarini¹, Giuseppe Pasini¹, Stefania Bartolini¹, Gianluca Marucci¹, Luca Morandi¹, Elena Zunarelli¹, Serenella Cerasoli¹, Giorgio Gardini¹, Giovanni Lanza¹, Enrico Maria Silini¹, Silvio Cavuto¹, Agostino Baruzzi¹, A Baruzzi, F Albani, F Calbucci, R D'Alessandro, R Michelucci, A Brandes, V Eusebi, S Ceruti, E Fainardi, R Tamarozzi, E Emiliani, M Cavallo, E Franceschi, A Tosoni, M Cavallo, F Fiorica, A Valentini, R Depenni, C Mucciarini, G Crisi, E Sasso, C Biasini, L Cavanna, D Guidetti, N Marcello, A Pisanello, A M Cremonini, G Guiducci, S de Pasqua, S Testoni, R Agati, G Ambrosetto, A Bacci, E Baldin, A Baldrati, E Barbieri, S Bartolini, E Bellavista, F Bisulli, E Bonora, F Bunkheila, V Carelli, M Crisci, P Dall'Occa, D de Biase, S Ferro, C Franceschi, G Frezza, V Grasso, M Leonardi, G Marucci, V Mazzocchi, L Morandi, B Mostacci, G Palandri, E Pasini, M Pastore Trossello, A Pession, M Ragazzi, P Riguzzi, R Rinaldi, S Rizzi, G Romeo, F Spagnolli, P Tinuper, C Trocino, S Cerasoli, M Dall'Agata, M Faedi, M Frattarelli, G Gentili, A Giovannini, P Iorio, U Pasquini, G Galletti, C Guidi, W Neri, A Patuelli, S Strumia, M Casmiro, A Gamboni, F Rasi, G Cruciani, P Cenni, C Dazzi, Ar Guidi, F Zumaglini, A Amadori, G Pasini, M Pasquinelli, E Pasquini, A Polselli, A Ravasio, B Viti, M Sintini, A Ariatti, F Bertolini, G Bigliardi, P Carpeggiani, F Cavalleri, S Meletti, P Nichelli, E Pettorelli, G Pinna, E Zunarelli, F Artioli, I Bernardini, M Costa, G Greco, R Guerzoni, C Stucchi, C Iaccarino, R Rizzi, G Zuccoli, P Api, F Cartei, E Fallica, E Granieri, F Latini, G Lelli, C Monetti, V Ramponi, A Saletti, R Schivalocchi, S Seraceni, M R Tola, B Urbini, C Giorgi, E Montanari, D Cerasti, P Crafa, I Dascola, I Florindo, S Mazza, F Servadei, Em Silini, P Torelli, P Immovilli, N Morelli, C Vanzo

Affiliations

Affiliation

¹ Department of Medical Oncology , Bellaria - Maggiore Hospital, IRCCS Institute of Neurological Science , Bologna , Italy (A.A.B., E.F., A.T., S.B.); Department of Neurosciences, Statistics and Informatics Unit , Azienda Ospedale-Università , Padova , Italy (M.E.); IRCCS Institute of Neurological Sciences , Bologna , Italy (F.A., A.B.); Department of Biomedical and Neuromotor Sciences , University of Bologna , Bologna , Italy (F.A., A.B.); Department of Oncology, Hematology and Respiratory Diseases , University Hospital of Modena , Modena , Italy (R.D.); Department of Oncology and Hematology , Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)-IRCCS Cesena , Italy (M.F.); Neurology Unit, IRCCS-Arcispedale Santa Maria Nuova , Reggio Emilia , Italy (A.P.); Department of Neuroradiology , University Hospital of Parma , Parma , Italy (G.C.); Clinical Oncology Unit , St Anna University Hospital , Ferrara , Italy (B.U.); Department of Oncology and Hematology , General Hospital , Ravenna , Italy (C.D.); Department of Oncology and Hematology, Oncology Unit , Azienda Ospedaliera Guglielmo da Saliceto , Piacenza , Italy (L.C.); Medical Oncology Unit , Ramazzini Hospital , Carpi , Italy (C.M.); Department of Medical Oncology , Infermi Hospital , Rimini , Italy (G.P.); Department of Biomedical and NeuroMotor Sciences (DiBiNeM) , University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital , Bologna , Italy (G.M., L.M.); Department of Pathology , Azienda Ospedaliero-Universitaria, Policlinico , Modena , Italy (E.Z.); Department of Human Pathology , AUSL Cesena Bufalini Hospital , Cesena , Italy (S.C.); Department of Pathology , IRCCS Arcispedale Santa Maria Nuova , Reggio Emilia , Italy (G.G.); Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale , Sezione di Anatomia Patologica e Diagnostica Biomolecolare, Università di Ferrara , Ferrara , Italy (G.L.); Pathology Unit , Azienda Ospedaliero-Universitaria , Parma , Italy (E.M.S.); Department "Infrastructure Research and Statistics," IRCCS-Arcispedale Santa Maria Nuova , Reggio Emilia , Italy (S.C.).

PMID: 26034628
PMCID: PMC4369716
DOI: 10.1093/nop/npu021

Pattern of care and effectiveness of treatment for glioblastoma patients in the real world: Results from a prospective population-based registry. Could survival differ in a high-volume center?

Alba A Brandes et al. Neurooncol Pract. 2014 Dec.

. 2014 Dec;1(4):166-171.

doi: 10.1093/nop/npu021. Epub 2014 Aug 28.

Authors

Affiliation

¹ Department of Medical Oncology , Bellaria - Maggiore Hospital, IRCCS Institute of Neurological Science , Bologna , Italy (A.A.B., E.F., A.T., S.B.); Department of Neurosciences, Statistics and Informatics Unit , Azienda Ospedale-Università , Padova , Italy (M.E.); IRCCS Institute of Neurological Sciences , Bologna , Italy (F.A., A.B.); Department of Biomedical and Neuromotor Sciences , University of Bologna , Bologna , Italy (F.A., A.B.); Department of Oncology, Hematology and Respiratory Diseases , University Hospital of Modena , Modena , Italy (R.D.); Department of Oncology and Hematology , Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)-IRCCS Cesena , Italy (M.F.); Neurology Unit, IRCCS-Arcispedale Santa Maria Nuova , Reggio Emilia , Italy (A.P.); Department of Neuroradiology , University Hospital of Parma , Parma , Italy (G.C.); Clinical Oncology Unit , St Anna University Hospital , Ferrara , Italy (B.U.); Department of Oncology and Hematology , General Hospital , Ravenna , Italy (C.D.); Department of Oncology and Hematology, Oncology Unit , Azienda Ospedaliera Guglielmo da Saliceto , Piacenza , Italy (L.C.); Medical Oncology Unit , Ramazzini Hospital , Carpi , Italy (C.M.); Department of Medical Oncology , Infermi Hospital , Rimini , Italy (G.P.); Department of Biomedical and NeuroMotor Sciences (DiBiNeM) , University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital , Bologna , Italy (G.M., L.M.); Department of Pathology , Azienda Ospedaliero-Universitaria, Policlinico , Modena , Italy (E.Z.); Department of Human Pathology , AUSL Cesena Bufalini Hospital , Cesena , Italy (S.C.); Department of Pathology , IRCCS Arcispedale Santa Maria Nuova , Reggio Emilia , Italy (G.G.); Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale , Sezione di Anatomia Patologica e Diagnostica Biomolecolare, Università di Ferrara , Ferrara , Italy (G.L.); Pathology Unit , Azienda Ospedaliero-Universitaria , Parma , Italy (E.M.S.); Department "Infrastructure Research and Statistics," IRCCS-Arcispedale Santa Maria Nuova , Reggio Emilia , Italy (S.C.).

PMID: 26034628
PMCID: PMC4369716
DOI: 10.1093/nop/npu021

Abstract

Background: As yet, no population-based prospective studies have been conducted to investigate the incidence and clinical outcome of glioblastoma (GBM) or the diffusion and impact of the current standard therapeutic approach in newly diagnosed patients younger than aged 70 years.

Methods: Data on all new cases of primary brain tumors observed from January 1, 2009, to December 31, 2010, in adults residing within the Emilia-Romagna region were recorded in a prospective registry in the Project of Emilia Romagna on Neuro-Oncology (PERNO). Based on the data from this registry, a prospective evaluation was made of the treatment efficacy and outcome in GBM patients.

Results: Two hundred sixty-seven GBM patients (median age, 64 y; range, 29-84 y) were enrolled. The median overall survival (OS) was 10.7 months (95% CI, 9.2-12.4). The 139 patients ≤aged 70 years who were given standard temozolomide treatment concomitant with and adjuvant to radiotherapy had a median OS of 16.4 months (95% CI, 14.0-18.5). With multivariate analysis, OS correlated significantly with KPS (HR = 0.458; 95% CI, 0.248-0.847; P = .0127), MGMT methylation status (HR = 0.612; 95% CI, 0.388-0.966; P = .0350), and treatment received in a high versus low-volume center (HR = 0.56; 95% CI, 0.328-0.986; P = .0446).

Conclusions: The median OS following standard temozolomide treatment concurrent with and adjuvant to radiotherapy given to (72.8% of) patients aged ≤70 years is consistent with findings reported from randomized phase III trials. The volume and expertise of the treatment center should be further investigated as a prognostic factor.

Keywords: center volume; glioblastoma; radiotherapy; surgery; temozolomide.

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Figures

**Fig. 1.**
Patient selection to achieve patients with glioblastoma aged ≤70 years and treated with radiotherapy/temozolomide.

See this image and copyright information in PMC

References

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Pattern of care and effectiveness of treatment for glioblastoma patients in the real world: Results from a prospective population-based registry. Could survival differ in a high-volume center?

Affiliation

Pattern of care and effectiveness of treatment for glioblastoma patients in the real world: Results from a prospective population-based registry. Could survival differ in a high-volume center?

Authors

Affiliation

Abstract

Figures

References