Abstract
Recurrent glioblastoma (GBM) remains one of the most challenging clinical issues, with no standard treatment and effective treatment options. To evaluate the efficacy of talaporfin sodium (TS) mediated photodynamic therapy (PDT) as a new treatment for this condition, we retrospectively analyzed 70 patients who underwent surgery with PDT (PDT group) for recurrent GBM and 38 patients who underwent surgery alone (control group). The median progression-free survival (PFS) in the PDT and control groups after second surgery was 5.7 and 2.2 months, respectively (p = 0.0043). The median overall survival (OS) after the second surgery was 16.0 and 12.8 months, respectively (p = 0.031). Both univariate and multivariate analyses indicated that surgery with PDT and a preoperative Karnofsky Performance Scale were significant independent prognostic factors for PFS and OS. In the PDT group, there was no significant difference regarding PFS and OS between patients whose previous pathology before recurrence was already GBM and those who had malignant transformation to GBM from lower grade glioma. There was also no significant difference in TS accumulation in the tumor between these two groups. According to these results, additional PDT treatment for recurrent GBM could have potential survival benefits and its efficacy is independent of the pre-recurrence pathology.
Highlights
Glioblastoma (GBM) is one of the most malignant primary brain tumors with a quite poor prognosis
Of the 69 patients in the photodynamic therapy (PDT) group with GBM, 43 had already been previously diagnosed with GBM based on pathology before recurrence, and 26 had been diagnosed as lower grade glioma (LGG)
There was no 1p/19q codeletion in any patient, and there was no difference in O-6-Methylguanine-DNA methyltransferase (MGMT) protein expression between the two groups (p = 0.73)
Summary
Glioblastoma (GBM) is one of the most malignant primary brain tumors with a quite poor prognosis. The standard treatment for newly diagnosed GBM is maximal surgical resection followed by radiotherapy with concomitant and adjuvant temozolomide-based chemotherapy. The median survival time for patients who complete the standard treatment is only about 15 months or less [1]. One factor that contributes to the unsatisfactory prognosis in GBM is that most recur following standard treatment. Pharmaceutics 2022, 14, 353 the therapeutic options include surgical rechallenge, additional existing chemotherapy, and additional radiation, but their efficacy is limited. The median overall survival (OS) after various retreatments for recurrent GBM has been reported at 6.5–7.6 months [2,3,4]. There is currently no standard treatment for recurrent GBM, because no existing therapy has demonstrated superiority [3,5,6]. New effective treatments for this condition are urgently required
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