Reply to glioblastoma in the Canton of Zurich, Switzerland revisited: 2005 to 2009.

Abstract

We appreciate the feedback of Drs. Caldarella and Barchielli concerning our recent analysis of patterns of care and outcome among patients with glioblastoma diagnosed in the Canton of Zurich, Switzerland, from 2005 to 2009.1 It is reassuring to us that our colleagues also report an improvement in outcome in their catchment area. For our patient cohort, we are confident that treatment information is rather complete because the majority of patients diagnosed with glioblastoma in the Canton of Zurich are treated at the University Hospital Zurich (>85% from 2005-2009), and because the University Hospital has had electronic charts since before 2005. Similarly, although no electronic charts were available for the earlier patient cohort (1980-1994), again only a few institutions outside the University Hospital treated these patients, and we assume that the collection of data via the Zurich and Zug Cancer Registry enabled us to obtain relatively complete data. We believe that the overall attitude toward patients with glioblastoma has changed over the last decades in that today only rarely is there no effort made at the histological verification of the diagnosis, and treatment intensity has increased both across patient age groups and regarding chemotherapy in the newly diagnosed setting as well as at the time of disease recurrence, using various approaches. Although the prognosis remains poor, as stated by Drs. Caldarella and Barchielli, there has undoubtedly been progress not only in prolonging life but also in the quality of life, and subgroups of patients with favorable prognostic factors may survive for many years, as documented by various publications from the German Glioma Network.2-4 Supported by a grant from the Krebsliga Zurich. Michael Weller has received research grants from Acceleron Pharma, Actelion Pharmaceuticals, Bayer, Piqur Therapeutics, and Phytopharmaceutical Sciences; grants and personal fees for lectures or advisory board participation from Isarna, MSD, Merck Serono, and Roche; and honoraria for lectures or advisory board participation from Celldex Therapeutics, MagForce AG, Pfizer, and Teva Pharmaceuticals for work performed outside of the current study. Dorothee Gramatzki, MD Michael Weller, MD Department of Neurology University Hospital Zurich Zurich, Switzerland