gms | German Medical Science

Objective: Throughout the past years, the primary therapy of glioblastoma has changed due to the introduction of ALA-fluorescence guided resection and concomitant radiochemotherapy according to the Stupp-scheme. The impact of these modifications on the prognosis of glioblastoma patients were the subject of this analysis.

Methods: Since 1998 epidemiological and clinical data on glioma patients were collected in the neurooncological database of our department. For the present analysis, 175 surgically treated, primary glioblastoma patients from the years 2000 to 2005 were classified according to surgery with or without ALA and adjuvant therapy with or without concomitant therapy.

Results: Patients not subjected to fluorescence-guided resections, nor to concomitant radiochemotherapy had a median survival time of only 11.4 months. In comparison, patients treated with fluorescence-guided resections and adjuvant concomitant radiochemotherapy survived a median of 16.7 months. ALA-guided resection significantly correlated with complete resections (p=0.012) and improved overall survival (9.5 months vs 16.9 months) (p=0.006). These groups did not significantly differ regarding age and pre-surgery Karnofsky Performance Score (KPS).

Conclusions: This single institution analysis mirrors that advances made in neurooncology during the last years, such as improved resections and radiochemotherapy using temozolomide, have had a significant impact on the outcome of patients with malignant gliomas.