GlioblastomaDelaying standard combined chemoradiotherapy after surgical resection does not impact survival in newly diagnosed glioblastoma patients
Section snippets
Patient population
Patients entered into the CASTE1 database, run by the Club de Neuro-Oncologie of the Société Française de Neurochirurgie between 2005 and 2011, constituted the study group for this article [29]. Inclusion criteria were: (1) patients older than 18 at diagnosis; (2) histologically confirmed supratentorial glioblastoma; (3) surgical resection followed by the standard combined chemoradiotherapy (radiotherapy, 60 Gy, and daily concomitant temozolomide at 75 mg/m2/day, then adjuvant temozolomide at
Results
Patients’ main characteristics are detailed in Table 1. A total of 692 patients (434 men, 258 women) were included, with a mean age of 57.5 ± 10.8 years. At diagnosis, 65.9% of patients presented with a neurological deficit, 34.2% with a Karnofsky performance status of 70 or less, and 55.1% with a RTOG-RPA class at 5 or 6. All patients underwent a surgical resection (65.5% total/subtotal resection, 34.5% partial resection), with carmustine wafer implantation in 36.7% of cases. A mean dose of
Discussion
Concern about glioblastoma regrowth [33], with the related risk of clinical degradation, has frequently led to consider a time interval of less than four to six weeks post surgical intervention as optimal in daily practice [28]. This question was initially raised in the era preceding the standard combined chemoradiotherapy. Do et al., showed on a retrospective study based on 182 patients with grade III/IV gliomas that the risk of death increased by 2% per day of waiting for radiotherapy [13].
Funding
None.
Conflict of interest
None.
Acknowledgments
Participating centers (in alphabetical order): Amiens University Hospital – University of Amiens, Angers University Hospital – Angers University, Jean-Minjoz Hospital – University of Besançon, Pellegrin Hospital – University Victor Segalen Bordeaux 2, Morvan Hospital – University of Brest, Caen University Hospital – University Caen Lower-Normandy, Pasteur Hospital in Colmar, Limoges Hospital – University of Limoges, Pierre Wertheimer Hospital – University of Lyon, La Timone Hospital –
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