Article
Comparison of the effect of different treatment strategies within discrepant healthcare systems on survival of glioblastoma patients
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Published: | June 9, 2017 |
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Objective: Whether an interdisciplinary treatment approach within a well-financed, robust healthcare system plays a significant role on the survival of glioblastoma patients remains unclear. The goal of this study was to examine survival in parallel cohorts of glioblastoma patients from two university hospitals with different treatment strategies functioning within two completely different healthcare systems.
Methods: We retrospectively analyzed two matched cohorts from a university hospital in Greece (188 patients) and Germany (189 patients). In both centers patients were treated with surgery followed by radiochemotherapy according to the stupp protocol. In case of recurrence, Greek patients were treated rather conservatively and the further therapeutic decisions were made by the primary treating physisian were as German patients were treated more aggressively, with a strategy that was developed within an inderdisciplinary tumorboard. The primary endpoint was progression-free and overall survival. Groups were compared using the Kaplan-Meier method for survival estimates.
Results: Both groups were comparable with respect to baseline parameters. Only 17% of Greek patients versus 88% of German patiens received second line treatment. Progression-free survival was similar for both patient cohorts (PFSGreece=9.9 months vs PFSGermany=9.0 months, p=0.37). Median survival was 12 months (95% CI, 9.4-14.5) and 16.6 months (95% CI, 13.3-19.8) for Greek and German patients respectively (p=0.02).
Conclusion: Treatment steared by a neurooncological tumorboard, functioning within a well financed-health care system and favoring second line treatment for recurrent glioblastomas was associated with significantly better overall survival.