Glioblastoma Multiforme: Five-year Experience at a Tertiary Cancer Centre in North India

Abstract

Background: Glioblastoma Multiforme (GBM) is one of the most common brain tumors. Despite multimodal treatment with surgery and chemoradiotherapy, survival outcome remains bleak. Many patients do not tolerate and complete such aggressive treatment. Our Center is the largest tertiary care referral hospital in the region; we report our findings about 5-year outcome in these patients. Methods: From January 2014 to December 2018, we conducted a retrospective observational study. We included patients with histopathologically proven diagnosis of GBM. Descriptive statistics of patient data was retrieved from patient files at Hospital Based Cancer Registry (HBCR) at our State Cancer Institute (SCI). All the data was recorded and analyzed using appropriate statistical methods. Results: 54 histopathologically proven cases of GBM were enrolled. Most patients were in the fifth and sixth decade of life, with a male to female ratio of 2:1. Headache was the most common presenting symptom in 23 (42.5%) patients followed by seizures in 13 (24%) patients. The average lesion size was 4.7 cm. Gross total excision was done in 12 (22%) patients, near total excision in 8 (15%) patients. 48 (89%) patients received radiation therapy concurrent with temozolomide. 4 (7.4%) patients had complete response with chemoradiotherapy. Median survival was 16 months. Patients who underwent Gross total excision or near total excision had a median survival of 15.9±3.56 months, whereas patients who underwent subtotal excision had a median survival of 8.29±4.14 months. Patients who completed trimodality therapy had better survival. Conclusion: Patients receiving trimodality therapy with gross total excision and adjuvant chemoradiation achieve best survival rates. Advanced age, poor performance score, larger tumor size, deep seated lesions, suboptimal tumor excision, and steroid dependency carry poor prognosis.