Glioblastoma patients in Slovenia from 1997 to 2008
Background. Glioblastoma is the most common primary brain tumour. It has poor prognosis despite some advances in treatment achieved in the last decade. In Slovenia are 50 to 60 glioblastoma patients diagnosed each year. To find if the current treatment options had any influence on survival of the Slovenian glioblastoma patients we are analysing their data in the period from the beginning of the year 1997 to the end of the year 2008.
Patients and methods. All patients treated at Institute of Oncology Ljubljana from 1997 to 2008 were included in the retrospective study. Demographics, treatment details, and survival time after diagnose were collected and statistically analysed for the group as a whole and for the subgroups.
Results. From 1997 to 2008 527 adult patients were diagnosed to have glioblastoma and referred for further treatment. Their median age was 59 year (range 20-85) and all but one had diagnosis confirmed by pathologist. Gross total resection was reported by surgeons in 261 (49.5%) patients; good functional status (WHO 0 or 1) after surgery had 336 (63.7%) patients, radiotherapy was performed in 422 (80.1%), of those in 317 (75.1%) with radical intent and of those 198 (62.5 %) received some form of systemic treatment (usually temozolomide). Median survival for all patients was 9.7 months. There was no difference in median survival before or after chemo-radiotherapy era for all patients or all treated patients. However, the overall survival for patients treated with radical intent was significantly better (11.4 months; p < 0.05). Better survival had also radically treated patients who received additional temozolomide therapy (11.4 vs. 13.1 months; p = 0.014). Longer survival was associated with younger age and good performance status, as well as with more extensive tumour resection. In patients treated with radical intent, good performance status, radiotherapy planning and additional temozolomide therapy the survival was significantly longer in multivariate analysis.
Conclusions. We were observing a gradual increase in survival of glioblastoma patients who were treated with radical intent in last decade. Functionally good surgery, advances in radiotherapy and addition of temozolomide all contributed to this increase. Though it seems that the increase of survival was more pronounced in certain subgroup we still could not exactly define them. Further research, especially in tumour biology and genetics is needed.