Background

The standard treatment of glioblastoma multiforme involves surgical resection followed by concurrent chemoradiation therapy and adjuvant temozolomide. The aim of this study was to evaluate the epidemiological and survival features of patients with glioblastoma multiforme treated at a community hospital.

Methods

We retrospectively analysed demographic details and outcome of 126 patients with biopsy proven glioblastoma from 2007 to 2012.

Results

126 patients were identified. Complete survival data was available on 106 patients.  Patients were divided into age group (<50; 50-70; >70) with an average age of 61 years. The majority had an ECOG PS of 0-1 (56%). 81% of patients underwent debulking surgery initially with 52% receiving adjuvant temozolomide. 24 patients had disease in the frontal lobes.  

Average survival across all patients was 412 days from histological diagnosis. Age was inversely proportional to survival: patients <50 years having an overall survival of 753 days; 50-70 years 365 days; and >70 years 280 days.

Patients receiving adjuvant temozolomide had a survival advantage over those who did not (581 versus 235 days). This was more pronounced in younger patients (survival 862 days in <50yrs; 492 days in 50-70yrs; 328 days in >70yrs group).

In patients who received adjuvant temozolamide, survival was significantly better in patients with lower ECOG PS:  ECOG 0-1(644 days) versus ECOG 3-4(378 days).

Those patients that proceeded to have further redo de-bulking surgery showed a significant survival advantage over patients not having further surgery (572 versus 375 days). Average survival for frontal tumours was 630 versus 360 days for non frontal tumours.

Conclusion

In comparison to the pivotal trial by Stupp et all^[1] our patients were older although the survival benefit of temozolomide and radiation therapy was still present. Younger patients, patients with frontal lobe tumours, and patients who underwent redo surgery had a better prognosis.