gms | German Medical Science

Objective: Glioblastoma multiforme (GBM) is the most malignant brain cancer with poor prognosis and limited survival of patients. Although complete microsurgical resection followed by adjuvant radiochemotherapy provides the best chance of survival, deep seated tumor location precludes surgery and therapeutic options are limited. Stereotactic biopsy offers histological diagnosis, but the benefit for the patient as a diagnostic measure is sometimes questioned. We therefore aimed to analyse the overall survival (OS) of patients with newly diagnosed GBM and further adjuvant therapy.

Methods: This retrospective, monocentric study analysed a cohort of 125 patients who underwent stereotactic biopsy confirming the diagnosis GBM between 2010 and 2017 in a specialized neuro-oncologic centre.

Results: Out of 125 patients (74 male/51 female) 52 patients (41.6%) underwent concomitant radiochemotherapy (RCTx), 15 patients (12%) underwent chemotherapy (CTx) with temozolamide and 32 patients (25.6%) were treated by radiation therapy (RTx) alone. In 54% of patients the MGMT promotor was methylated, in only one patient IDH1 was mutated. Mean OS was 6.1 months (min 0.5/max 78 months). OS for patients with concomitant RCTX was 10.9 months (min 0.5/max 78 months), for CTx 4.3 months(min 1/max 13 months) and for RTx 2.5 months (min 0.5/max 10 months). For the 26 patients (20.8 %) who received no further therapy mean an OS of 1.8 months was found (min 0.5/max 19 months). Majority of patients were older than 60 years. 5 patients survived more than 2 years. Two of them were alive more than 5 years after diagnosis.

Conclusion: Histological and molecular diagnosis should be enforced by stereotactic biopsy in patients with newly diagnosed GBM’s. Although only in very few patients long term survival was seen in this series.