Impact of timing of radiotherapy in patients with newly diagnosed glioblastoma

Clin Neurol Neurosurg. 2016 Dec;151:73-78. doi: 10.1016/j.clineuro.2016.10.012. Epub 2016 Oct 22.

Abstract

Objective: To further evaluate if a delay in the start of radiation therapy (RT) affects patient outcomes for glioblastoma (GBM).

Patients and methods: From May 1999 to May 2010, a total of 161 patients underwent surgery followed by RT for GBM. We assessed overall survival (OS) and progression free survival (PFS), stratified by extent of surgical resection. Included in the analysis were genomic predictors of progression.

Results: Median time from surgery to start of RT was 20days for biopsy alone, 28days for subtotal resection (STR) and 28days for gross total resection (GTR). For all patients, a delay >28days did not result in a difference in PFS when compared to no delay (6.7 vs. 6.9 months, p=0.07). PFS was improved in biopsy or STR patients with a >28day delay to start of RT (4.2 vs. 6.7 months, p=0.006). OS was also improved in patients receiving biopsy or STR with a >28day delay to start of RT (12.3 vs. 7.8 months, p=0.005). Multivariable analysis (MVA) demonstrated an improvement in OS and PFS with time to RT >28days for biopsy or STR patients (HR 0.52 p=0.008 and HR 0.48 p=0.02, respectively).

Conclusion: In this retrospective review of GBM patients treated at a single institution, OS and PFS were not different between time to RT >28days compared to <28 days. There was a modest improvement in both PFS and OS in patients who received biopsy or STR with time to RT >28 days.

Keywords: Delay in radiation; GBM; Glioblastoma; Radiation; Time to radiation; Time to radiation following surgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms* / mortality
  • Brain Neoplasms* / radiotherapy
  • Brain Neoplasms* / surgery
  • Female
  • Follow-Up Studies
  • Glioblastoma* / mortality
  • Glioblastoma* / radiotherapy
  • Glioblastoma* / surgery
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Radiotherapy, Adjuvant / methods*
  • Retrospective Studies
  • Time Factors
  • Young Adult