gms | German Medical Science

Objective: Fluorescence-guided surgery (FGS) and concomitant radiochemotherapy (Stupp protocol) have recently been introduced as treatment options for patients suffering from Glioblastoma multiforme (GBM). As large multicentre trials have demonstrated the efficacy of these options, we were interested in the impact on the overall survival (OAS) and on the progression-free survival (PFS) of patients treated for GBM in our centre.

Methods: Treatment strategies for patients subject to cytoreductive surgery between 2002 and 2007 for newly diagnosed, primary GBM were retrospectively determined. Patients were divided into Group A (FGS-/Stupp-), Group B (FGS+/Stupp-), Group C (FGS-/Stupp+) and Group D (FGS+/Stupp+). Caplan-Meyer analysis on the groups and regression analysis were conducted for age, gender distribution and preoperative KPS.

Results: A total of 169 patients were included (group A=57, B=43, C=16, D=53). The median PFS and OAS between group A and D differed significantly (7.2 vs 10.0 months; p=0.008 and 10.7 vs 19.3 months; p=0.002). The median PFS and OAS for Group B and C were (5.5.vs 8.2 months; p=0.059 and 13.6 vs 16.3 months; p=0.178). Multivariate analysis revealed no significant differences between group A through D regarding age and preoperative KPS.

Conclusions: The introduction of FGS and the Stupp protocol induced an impressive improvement of PFS and OAS of GBM patients in our centre. Despite the limitations of a single centre study, effects were highly significant. In summary, our study suggests that these treatment options should be available in all centres specialized in the care of GBM patients.