Improved survival time trends for glioblastoma using the SEER 17 population-based registries
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The EORTC/NCIC 22981/26981 study demonstrated an improvement in median overall survival (OS) from 12.1 to 14.6 months in patients with glioblastoma (GBM) who received temozolomide with post-operative radiotherapy (RT). The current study was performed to determine if those results translated into a survival benefit in a population-based cohort. Patients diagnosed between 2000 and 2006 with a GBM who underwent surgery and post-operative RT were selected from the Surveillance, Epidemiology and End Results database. Patients were grouped into time periods: 2000–2001, 2002–2003, 2004 and 2005–2006 (which represented those treated after the EORTC/NCIC trial presentation in 2004). Relative survival (RS) was estimated by the Kaplan–Meier method, and Cox multivariable regression modeling was used to estimate proportional hazard ratios (HR). Over time, there was improvement in the median and 2-year RS of 12 months and 15% for 2000–2001, 13 months and 19% for 2002–2003, 14 months and 24% for 2004, and 15 months and 26% for 2005–2006 (P < 0.0001 compared to 2000–2001 and 2002–2003; P = 0.07 compared to 2004). The estimated adjusted HR showed that patients diagnosed in 2005–2006 had significantly improved survival when compared to patients diagnosed in 2000–2001 (HR = 0.648, 95% CI 0.604–0.696). The median and 2 year RS of 15 months and 26% in 2005–2006 was similar to the median and 2 year OS of 14.6 months and 26% seen in the EORTC/NCIC phase III study. These results are encouraging and suggest that the current treatment of glioblastoma nationwide is now associated with an improved survival compared to previous time cohorts.
KeywordsGlioblastoma Radiation Temozolomide SEER
This work was presented at the Annual American Society of Clinical Oncology Meeting June 3rd, 2011.
Funding for Therese Dolecek and Bridget McCarthy was supported by the Central Brain Tumor Registry of the United States (CBTRUS) that receives support from the American Brain Tumor Association, the National Brain Tumor Society, the Pediatric Brain Tumor Foundation and from the Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, under contract # HHSN261201000576P.
Conflict of interest
No author indicated a conflict of interest.
- 5.CBTRUS (2010) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2004–2007Google Scholar
- 9.Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, Ludwin SK, Allgeier A, Fisher B, Belanger K 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 10:459–466. doi: 10.1016/S1470-2045(09)70025-7 PubMedCrossRefGoogle Scholar
- 10.Linz U (2010) Commentary on effects of radiotherapy with concomitant, 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.2009;10:459–466). Cancer 116:1844–1846. doi: 10.1002/cncr.24950 PubMedCrossRefGoogle Scholar
- 11.National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch (Released April 2010, based on the November 2009 submission) Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence—SEER 17 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2009 Sub (1973–2007 varying)—Linked To County Attributes—Total U.S., 1969–2009 Counties
- 13.Surveillance Research Program, National Cancer Institute SEER*Stat software (seer.cancer.gov/seerstat). Version 7.0.4Google Scholar
- 14.Westphal M, Hilt DC, Bortey E, Delavault P, Olivares R, Warnke PC, Whittle IR, Jaaskelainen J, Ram Z (2003) A phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant glioma. Neuro Oncol 5:79–88. doi: 10.1215/S1522-8517-02-00023-6 PubMedGoogle Scholar
- 15.Stark-Vance V (2005) Bevacizumab and CPT-11 in the treatment of relapsed malignant glioma (Abstract). Neuro-oncology 7:369Google Scholar
- 18.Cardinale R, Won M, Choucair A, Gillin M, Chakravarti A, Schultz C, Souhami L, Chen A, Pham H, Mehta M (2006) A phase II trial of accelerated radiotherapy using weekly stereotactic conformal boost for supratentorial glioblastoma multiforme: RTOG 0023. Int J Radiat Oncol Biol Phys 65:1422–1428. doi: 10.1016/j.ijrobp.2006.02.042 PubMedCrossRefGoogle Scholar
- 23.Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, Lang FF, McCutcheon IE, Hassenbusch SJ, Holland E et al (2001) A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 95:190–198. doi: 10.3171/jns.2001.95.2.0190 PubMedGoogle Scholar
- 24.Albert FK, Forsting M, Sartor K, Adams HP, Kunze S (1994) Early postoperative magnetic resonance imaging after resection of malignant glioma: objective evaluation of residual tumor and its influence on regrowth and prognosis. Neurosurgery 34:45–60; discussion 60-1Google Scholar
- 25.Albert FK, Forsting M (2003) Resection and prognosis. J Neurosurg 98:225–226; author reply 226Google Scholar
- 26.Gorlia T, van den Bent MJ, Hegi ME, Mirimanoff RO, Weller M, Cairncross JG, Eisenhauer E, Belanger K, Brandes AA, Allgeier A et al (2008) Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981-22981/CE.3. Lancet Oncol 9:29–38. doi: 10.1016/S1470-2045(07)70384-4 PubMedCrossRefGoogle Scholar
- 28.Scott CB, Scarantino C, Urtasun R, Movsas B, Jones CU, Simpson JR, Fischbach AJ, Curran WJ Jr (1998) Validation and predictive power of Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis classes for malignant glioma patients: a report using RTOG 90-06. Int J Radiat Oncol Biol Phys 40:51–55PubMedCrossRefGoogle Scholar
- 29.Jeremic B, Milicic B, Grujicic D, Dagovic A, Aleksandrovic J (2003) Multivariate analysis of clinical prognostic factors in patients with glioblastoma multiforme treated with a combined modality approach. J Cancer Res Clin Oncol 129:477–484. doi: 10.1007/s00432-003-0471-5 PubMedCrossRefGoogle Scholar
- 32.Yu JB, Gross CP, Wilson LD, Smith BD (2009) NCI SEER public-use data: applications and limitations in oncology research. Oncology 23Google Scholar
- 33.Grossman SA, Ye X, Piantadosi S, Desideri S, Nabors LB, Rosenfeld M, Fisher J, Consortium NABTTCNS (2010) Survival of patients with newly diagnosed glioblastoma treated with radiation and temozolomide in research studies in the United States. Clin Cancer Res 16:2443–2449. doi: 10.1158/1078-0432.CCR-09-3106 PubMedCrossRefGoogle Scholar