Prognostic Factors Affecting the Outcome in Glioblastoma Multiforme: A Single Institution Experience

Abstract

Purpose: Glioblastoma multilorme (GBM) is the most malignant primary brain tumor in adults, Here we presented our institution experience of treatment resu1ts in Taiwan GBM patients and analyzed the prognostic factors. Materials and Methods: From Apri1 1998 to August 2010, 30 patients with GBM received tumor excision and radiotherapy with/without chemotherapy in our institution. Sixteen patients were ma1e (53%), and 14 were female (47%). The median age was 61 years. The performances status of Karnofsky Performance Sca1e was ≥70 in 19 patients (63%), and ＜70 in 11 patients (37%). The median size of tumor was 5.0 cm. All patients had definitive or post-operative adjuvant radiotherapy with/without chemotherapy. The median total radiation dose was 5940 cGy. Thirteen patients (43%) received chemotherapy. The chemotherapy regimens included ACNU, BCNU and Temozolomide. The follow-up period ranged from 1.2 to 49.3 months (median, 10.4 months) Results: Eight patients (27%) had tumor response after treatments, 19 patients (63%) had progression of disease, and 3 patients (10%) had stable disease. The median survival duration was 10.4 months. Five patients (17%) were alive and 25 patients (83%) were dead at the 1ast 101l0w-up. The 1-year overall surviva1 was 49%, and the 2-year overall survival was 17%. Performance status was a statistically significant factor for overall surviva1 (p= 0.008, log-rank test; p= 0.025, Cox proportiona1 hazards model). Conclusion: Despite recent therapeutic advances, the prognosis of GBM remains poor. Poor response to current therapies and loco-regional recurrence still were the main failure patterns for GBM. A large series of more patients with longer follow-up and more effective treatments is warranted.