Journal of Neuro-Oncology

, Volume 95, Issue 3, pp 301–305 | Cite as

Neurological outcome of long-term glioblastoma survivors

  • Andreas F. Hottinger
  • Hannah Yoon
  • Lisa M. DeAngelis
  • Lauren E. Abrey
Topic Review


Extended survival of 3 or more years is rare in patients with glioblastoma (GBM) but is becoming more common. Clinical outcome has not been well studied. We reviewed GBM patients at Memorial Sloan-Kettering Cancer Center between 2001 and 2003 who were seen for two or more visits. Patient characteristics and long-term clinical outcomes were reviewed for patients who had survived 3 or more years following diagnosis. Thirty-nine (11%) of 352 GBM patients were identified as long-term survivors. Median survival was 9.15 years (range: 3–18 years). Median age was 47 years (range: 16–69); 13% were 65 years or older. Median KPS was 90 (range: 50–100). One long-term survivor underwent biopsy alone; 19 patients each had either complete or subtotal resection. All received focal radiotherapy (RT) with a median dose of 5940 cGy; 18% received concurrent temozolomide. Adjuvant chemotherapy was administered to 35 (90%). Twelve patients (31%) remained in continuous remission. Twenty-seven had tumor progression a median of 29.2 months after diagnosis (range: 1.2–167 months); 18 had multiple relapses. Median KPS at last follow-up was 70 (range: 40–100); 85% of long-term survivors had at least one significant neurologic deficit. Eleven (28%) had clinically significant RT-induced leukoencephalopathy, 9 (23%) developed RT necrosis and 9 (23%) treatment-related strokes. Treatment-related complications occurred a median of 2.7 years from diagnosis (range: 0.9–11.5 years). Long-term survivors remain rare, but are found across all age groups despite multiple recurrences; clinically significant delayed complications of treatment are common.


Glioblastoma Long-term survivors Quality of life 


  1. 1.
    DeAngelis LM (2001) Brain tumors. N Engl J Med 344:114–123CrossRefPubMedGoogle Scholar
  2. 2.
    Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996CrossRefPubMedGoogle Scholar
  3. 3.
    Schmidinger M, Linzmayer L, Becherer A, Fazeny-Doemer B, Fakhrai N, Prayer D, Killer M, Ungersboeck K, Dieckmann K, Marosi C (2003) Psychometric- and quality-of-life assessment in long-term glioblastoma survivors. J Neuro-oncol 63:55–61CrossRefGoogle Scholar
  4. 4.
    Chandler KL, Prados MD, Malec M, Wilson CB (1993) Long-term survival in patients with glioblastoma multiforme. Neurosurgery 32:716–720 (discussion 720)CrossRefPubMedGoogle Scholar
  5. 5.
    Morita M, Rosenblum MK, Bilsky MH, Fraser RA, Rosenfeld MR (1996) Long-term survivors of glioblastoma multiforme: clinical and molecular characteristics. J Neuro-oncol 27:259–266CrossRefGoogle Scholar
  6. 6.
    Salford LG, Brun A, Nirfalk S (1988) Ten-year survival among patients with supratentorial astrocytomas grade III and IV. J Neurosurg 69:506–509CrossRefPubMedGoogle Scholar
  7. 7.
    Scott JN, Rewcastle NB, Brasher PM, Fulton D, Hagen NA, MacKinnon JA, Sutherland G, Cairncross JG, Forsyth P (1998) Long-term glioblastoma multiforme survivors: a population-based study. Can J Neurol Sci 25:197–201CrossRefPubMedGoogle Scholar
  8. 8.
    Burton EC, Lamborn KR, Feuerstein BG, Prados M, Scott J, Forsyth P, Passe S, Jenkins RB, Aldape KD (2002) Genetic aberrations defined by comparative genomic hybridization distinguish long-term from typical survivors of glioblastoma. Cancer Res 62:6205–6210PubMedGoogle Scholar
  9. 9.
    Ammirati M, Vick N, Liao YL, Ciric I, Mikhael M (1987) Effect of the extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic astrocytomas. Neurosurgery 21:201–206CrossRefPubMedGoogle Scholar
  10. 10.
    Scheibel RS, Meyers CA, Levin VA (1996) Cognitive dysfunction following surgery for intracerebral glioma: influence of histopathology, lesion location, and treatment. J Neuro-oncol 30:61–69CrossRefGoogle Scholar
  11. 11.
    Taylor BV, Buckner JC, Cascino TL, O’Fallon JR, Schaefer PL, Dinapoli RP, Schomberg P (1998) Effects of radiation and chemotherapy on cognitive function in patients with high-grade glioma. J Clin Oncol 16:2195–2201CrossRefPubMedGoogle Scholar
  12. 12.
    Muller H, Brock M, Ernst H (1985) Long-term survival and recurrence-free interval in combined surgical, radio- and chemotherapy of malignant brain gliomas. Clin Neurol Neurosurg 87:167–171CrossRefPubMedGoogle Scholar
  13. 13.
    Salcman M, Scholtz H, Kaplan RS, Kulik S (1994) Long-term survival in patients with malignant astrocytoma. Neurosurgery 34:213–219 (discussion 219–220)CrossRefPubMedGoogle Scholar
  14. 14.
    Stupp R, Hegi ME, Mason WP, et al. (2009) Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol [Epub ahead of print]Google Scholar
  15. 15.
    Bahr O, Herrlinger U, Weller M, Steinback JP (2009) Very late relapses in glioblastoma long-term survivors. J Neurol [Epub ahead of print]Google Scholar
  16. 16.
    Krex D, Klink B, Hartmann C et al (2007) Long-term survival with glioblastoma multiforme. Brain 130:2596–2606CrossRefPubMedGoogle Scholar
  17. 17.
    Steinbach JP, Blaicher H-P, Herrlinger U et al (2006) Surviving glioblastoma for more than 5 years: the patient’s prospective. Neurology 66:239–242CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Andreas F. Hottinger
    • 1
  • Hannah Yoon
    • 1
  • Lisa M. DeAngelis
    • 1
  • Lauren E. Abrey
    • 1
  1. 1.Department of NeurologyMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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