gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Retrospective analysis of current therapy modalities in 200 patients with glioblastoma multiforme over a 5-year period

Retrospektive Analyse zeitgemäßer Therapiemodalitäten bei 200 Patienten mit Glioblastoma multiforme über einen Zeitraum von 5 Jahren

Meeting Abstract

  • corresponding author H.C. Bock - Klinik für Neurochirurgie, Universitätsklinikum Göttingen
  • Y. Echegoyen - Klinik für Neurochirurgie, Universitätsklinikum Göttingen
  • J. Hinz - Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Göttingen
  • A. Gutenberg - Klinik für Neurochirurgie, Universitätsklinikum Göttingen
  • H. Strik - Klinik für Neurologie, Universitätsklinikum Göttingen
  • A. Giese - Klinik für Neurochirurgie, Universitätsklinikum Göttingen
  • V. Rohde - Klinik für Neurochirurgie, Universitätsklinikum Göttingen

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocFR.04.03

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc087.shtml

Published: April 11, 2007

© 2007 Bock et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Over the last decades therapeutic strategies for patients with newly diagnosed GBM were characterized by differences in operating techniques, radiotherapy as well as various modalities of chemotherapy. Typically departments will follow recommended therapies based on international studies. However, the benefit of a patient population in clinical practice of a given center needs continuous reevaluation.

Methods: We have developed a tumor patient data bank based on MS Access to analyze the clinical courses, tumor progression and survival in over 200 patients with glioblastoma multiforme treated over a 5-year period (2000 until 2004) at our institution. The data base collects data considering epidemiological values, neurological performance, operation technique, extent of resection, histological parameters and molecular genetic CGH analysis, radiotherapy-modalities and chemotherapy protocols.

Results: The surgically treated patient collective could be divided into different groups of patients which received one or more operations with and without radiotherapy or additional chemotherapy treatment (ACNU, PCV or TMZ). Karnofsky score before first surgery ranged between 20 and 90 (5%< 40, 72% 50-70, 23% >70). 29% of all patients underwent a second resection and 8% third surgery after tumor progression. In 21% of the patient biopsy alone was carried out to obtain diagnosis, 33% underwent subtotal and 46% macroscopically complete resection at first surgery. In 71% of all cases radiation therapy was carried out, 52% received chemotherapy after first surgery (21% ACNU, 14% PCV, and 65% TMZ); only 4% underwent chemotherapy after a second resection following tumor progression. Longest chemotherapy interval without tumor progression was found for TMZ with 75 cycles and longest total survival was 84 months.

Conclusions: Overall survival and time to tumor progression in our patient population demonstrated significant differences between therapy modalities. Interestingly, with changing treatment plans and departmental preferences over time the outcome of the patient population varies indicating that a continuous reevaluation of treatment strategies in clinical practice helps to detect improvements as well as suboptimal strategies and therefore need to be part of a departmental quality control.