Abstract
BackgroundFindings of both case control and in vitro investigations suggest that non-steroidal anti-inflammatory drugs (NSAIDs) may play a beneficial role in the occurrence, growth, and subsistence of glioblastoma multiforme (GBM) brain tumor in humans.ObjectiveIn the present retrospective cohort study, we assessed the impact of NSAID use on survival in patients diagnosed with and treated for GBM brain tumors.MethodsThe impact of NSAID use and six other potential prognostic indicators of survival were assessed in 71 patients treated for GBM brain tumors from February 2011 to June 2016. Survival analysis and cross-tabulation analyses were performed to examine the potential relationship between NSAID use and occurrence of intracranial hemorrhage over the course of treatment for GBM.ResultsKaplan-Meier analysis revealed no significant difference in survival between patients with and without NSAID use (p = 0.75; 95% CI: 10.12, 18.13). Multiple Cox regression analysis identified only treatment with chemotherapy as imposing any statistically significant effect on survival (Hazard Ratio (HR) = 3.31; p < 0.001; 95% CI: 1.80, 6.07). Cross-tabulation revealed no significant effect of NSAID use on occurrence of hemorrhage during treatment, X2 (2, N = 71) = 0.65, p2-Sided = 0.42, (Fisher’s Exact Test: p2-sided = 0.56, p1-sided = 0.31).ConclusionThese results suggest that history of NSAID use is not a determinant of survival in GBM patients. More rigorous, prospective investigations of the effect of NSAID use on tumor progression are necessary before the utility of this family of drugs in the treatment of GBM can be adequately appraised.
Highlights
Glioblastoma multiforme (GBM) is the most aggressive and commonly occurring primary intracranial tumor, conferring a median survival of 10–14 months following multi-modal treatment [1]
Kaplan-Meier analysis revealed no significant difference in survival between patients with and without non-steroidal antiinflammatory drugs (NSAIDs) use (p = 0.75; 95% CI: 10.12, 18.13)
These results suggest that history of NSAID use is not a determinant of survival in glioblastoma multiforme (GBM) patients
Summary
Glioblastoma multiforme (GBM) is the most aggressive and commonly occurring primary intracranial tumor, conferring a median survival of 10–14 months following multi-modal treatment [1]. Sareddy et al (2012) described the dosedependent, anti-proliferative, and pro-apoptotic effects of the non-reversible COX-2 inhibitor, celecoxib, in GBM cell lines, demonstrating its potential inhibitory roll in the NF-κB pathway [4]. Examples include the upregulation of 15-hydroxyprostaglandin dehydrogenase (15-PGDH, a key inactivator of prostaglandins) and the cell cycle regulator p21 in GBM cell lines treated with dissolved Diclofenac sodium and meloxicam sodium [10]. Findings of both case control and in vitro investigations suggest that non-steroidal antiinflammatory drugs (NSAIDs) may play a beneficial role in the occurrence, growth, and subsistence of glioblastoma multiforme (GBM) brain tumor in humans
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