Survival and Prognostic Factors in Patients with Glioblastoma Multiforme Receiving Radiation and Temozolomide – A Retrospective Study

Abstract

Introduction: Glioblastoma multiforme (GBM) is the most common primary brain tumor in adults. The standard treatment is surgical excision, followed by concomitant chemoradiation and adjuvant treatment with temozolomide. The standard radiation dose is 60Gy/ 30 fractions 2 Gy per fraction. Temozolomide is an alkylating agent and dosage is 75mg/m2 concurrent with radiation and 150-200mg/m2 as adjuvant treatment. This study aims at studying the median survival and the various prognostic factors. Materials and Methods: This is a retrospective study conducted in Government Medical College, Alappuzha, of 44 patients with GBM from March 2015-2017, who underwent surgery followed by chemoradiation with temozolomide and six cycles of adjuvant temozolomide. Result: Out of 44 patients, 26 were males and 18 females. There were 28(64%) patients with an ECOG performance status (PS) of 0-1 and had a median survival (MS) of 21months and 16(36%) patients with PS of 2 who had a MS of 10 months (p value <0.001). In this study 30(68%) patients had complete or near complete excision and had a MS of 20 months and 14 (32%) patients had only a partial excision who had a MS of 10 months(p value <0.001). There were 25(57%) patients below 50 years who had a MS of 20 months and 19(43%) patients above 50 years who had a MS of 12 months (p value <0.01). Conclusion: The prognostic factors detected were age, performance status and extent of resection. The triple modality of treatment of concurrent chemoradiation with temozolomide followed by adjuvant temozolomide continues to be the standard treatment. Keywords: Glioblastoma multiforme, Temozolomide, chemoradiation.