Skip to main content
SpringerLink
Log in

Waiting times before initiation of radiotherapy might not affect outcomes for patients with glioblastoma: a French retrospective analysis of patients treated in the era of concomitant temozolomide and radiotherapy

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose of this study was to determine the effect of waiting time for radiotherapy on overall survival of patients with glioblastoma treated in the EORTC-NCIC trial at 18 centers in France. A total of 400 adult patients with glioblastoma who were treated between January 1, 2006 and December 31, 2006 were included. There were 282 patients with “minimum criteria” according to the EORTC-NCIC trial: (i) concurrent chemotherapy with temozolomide; and (ii) age between 18 and 70 years old. Among these patients, 229 were treated with adjuvant temozolomide and were classified as “maximal criteria”. One-hundred and eighteen patients were in the “without minimal criteria” group. Waiting time from the first symptom (FS-RT), pathology diagnosis (P-RT), multidisciplinary meeting (MM-RT), surgery (S-RT), and CT scan for delineation (CT-RT) until the start of radiotherapy were recorded. Median follow-up for all patients was 327 days. Overall, median FS-RT, P-RT, MM-RT, CT-RT, and S-RT times were 77, 36, 32, 12, and 41 days, respectively. Median, and 12 and 24-month overall survival were 409 days, and 56.3 ± 2.1 % and 27.6 ± 2.6 %, respectively. Univariate analysis failed to reveal a difference in survival, irrespective of the delay. In multivariate analysis, independent favorable prognostic factors for overall survival were age (p ≤ 0.0001) and type of surgery (p = 0.0006). In this large series treated during the EORTC-NCIC protocol period, waiting time until radiotherapy did not seem to affect patient outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Mackillop WJ (2007) Killing time: the consequences of delays in radiotherapy. Radiother Oncol 84:1–4

    Article  PubMed  Google Scholar 

  2. Barton MB, Morgan G, Smee R, Tiver KW, Hamilton C, Gebski V (1997) Does waiting time affect the outcome of larynx cancer treated by radiotherapy? Radiother Oncol 44:137–141

    Article  PubMed  CAS  Google Scholar 

  3. Brouha XD, Op De Coul B, Terhaard CH, Hordijk GJ (2000) Does waiting time for radiotherapy affect local control of T1N0M0 glottic laryngeal carcinoma? Clin Otolaryngol Allied Sci 25:215–218

    Article  PubMed  CAS  Google Scholar 

  4. Buchholz TA, Austin-Seymour MM, Moe RE et al (1993) Effect of delay in radiation in the combined modality treatment of breast cancer. Int J Radiat Oncol Biol Phys 26:23–35

    Article  PubMed  CAS  Google Scholar 

  5. Hartsell WF, Recine DC, Griem KL, Murthy AK (1995) Delaying the initiation of intact breast irradiation for patients with lymph node positive breast cancer increases the risk of local recurrence. Cancer 76:2497–2503

    Article  PubMed  CAS  Google Scholar 

  6. Lee AW, Chan DK, Fowler JF et al (1994) T1 nasopharyngeal carcinoma: the effect of waiting time on tumor control. Int J Radiat Oncol Biol Phys 30:1111–1117

    Article  PubMed  CAS  Google Scholar 

  7. Recht A, Come SE, Henderson IC et al (1996) The sequencing of chemotherapy and radiation therapy after conservative surgery for early-stage breast cancer. N Engl J Med 334:1356–1361

    Article  PubMed  CAS  Google Scholar 

  8. Choi N, Baumann M, Flentjie M et al (2001) Predictive factors in radiotherapy for non-small cell lung cancer: present status. Lung Cancer 31:43–56

    Article  PubMed  CAS  Google Scholar 

  9. Tsai CS, Lai CH, Wang CC et al (1999) The prognostic factors for patients with early cervical cancer treated by radical hysterectomy and postoperative radiotherapy. Gynecol Oncol 75:328–333

    Article  PubMed  CAS  Google Scholar 

  10. Do V, Gebski V, Barton MB (2000) The effect of waiting for radiotherapy for grade III/IV gliomas. Radiother Oncol 57:131–136

    Article  PubMed  CAS  Google Scholar 

  11. Irwin C, Hunn M, Purdie G, Hamilton D (2007) Delay in radiotherapy shortens survival in patients with high grade glioma. J Neurooncol 85:339–343

    Article  PubMed  Google Scholar 

  12. Lopez, S, Calugaru, V, Lamproglou, I, et al. (2008) Les effets de la liste d’attente sur la survie des patients atteints de glioblastome traité par irradiation. Cancer/Radiothér 12(8):827–830

    Google Scholar 

  13. Noel G, Quetin P, Heymann S, Karamanoukian D, Schott R (2009) Waiting times do not negatively modify outcome of patients with multiform glioblastoma. Cancer Radiother 13:17–23

    Article  PubMed  CAS  Google Scholar 

  14. Lai R, Hershman DL, Doan T, Neugut AI (2010) The timing of cranial radiation in elderly patients with newly diagnosed glioblastoma multiforme. Neurooncology 12:190–198

    Google Scholar 

  15. Blumenthal DT, Won M, Mehta MP et al (2009) Short delay in initiation of radiotherapy may not affect outcome of patients with glioblastoma: a secondary analysis from the radiation therapy oncology group database. J Clin Oncol 27:733–739

    Article  PubMed  Google Scholar 

  16. Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996

    Article  PubMed  CAS  Google Scholar 

  17. Lawrence YR, Blumenthal DT, Matceyevsky D, Kanner AA, Bokstein F, Corn BW (2011) Delayed initiation of radiotherapy for glioblastoma: How important is it to push to the front (or the back) of the line? J Neurooncol 105:1–7

    Article  PubMed  CAS  Google Scholar 

  18. 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 10:459–466

    Article  PubMed  CAS  Google Scholar 

  19. Burnet NG, Jena R, Jefferies SJ, Stenning SP, Kirkby NF (2006) Mathematical modelling of survival of glioblastoma patients suggests a role for radiotherapy dose escalation and predicts poorer outcome after delay to start treatment. Clin Oncol (R Coll Radiol) 18:93–103

    Article  CAS  Google Scholar 

  20. Taghian A, Ramsay J, Allalunis-Turner J et al (1993) Intrinsic radiation sensitivity may not be the major determinant of the poor clinical outcome of glioblastoma multiforme. Int J Radiat Oncol Biol Phys 25:243–249

    Article  PubMed  CAS  Google Scholar 

  21. Mackillop WJ, Bates JH, O’Sullivan B, Withers HR (1996) The effect of delay in treatment on local control by radiotherapy. Int J Radiat Oncol Biol Phys 34:243–250

    Article  PubMed  CAS  Google Scholar 

  22. Luchi T, Hatano K, Kodama, T, et al. (2010) Brain deformation after surgery of glioblastoma should we take MRI for planning of irradiation? Radiother Oncol 96:S256 (abst. 708)

  23. Peker S, Abacioglu U, Sun I, Yuksel M, Pamir MN (2004) Irradiation after surgically induced brain injury in the rat: timing in relation to severity of radiation damage. J Neurooncol 70:17–21

    Article  PubMed  Google Scholar 

Download references

Conflicts of Interest

All authors declared no conflicts of interest.

Author information

Authors and Affiliations

  1. CLCC Paul Strauss, 3 Rue de la Porte de l’Hôpital, 67065, Strasbourg Cedex, France

    Georges Noel & Jean-Baptiste Clavier

  2. CHU de Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France

    Aymeri Huchet & Jean Philippe Maire

  3. CHU Pitié-Salpêtrière, 47-83, Bd de l’Hôpital, 75065, Paris Cedex 13, France

    Loic Feuvret

  4. CLCC Jean Perrin, 58, Rue Montalembert, 63011, Clermont-Ferrand Cedex 01, France

    Pierre Verrelle & Xavier Durando

  5. CLCC Oscar Lambret, 3, Rue Frédéric Combemale BP 307, 59020, Lille Cedex, France

    Emilie Le Rhun

  6. CLCC René Gauducheau, Boulevard Jacques Monod, 44805, Nantes Saint-Herblain Cedex, France

    Maud Aumont & François Thillays

  7. CLCC Léon Bérard, 28, Rue Laënnec, 69373, Lyon Cedex 08, France

    Marie Pierre Sunyach

  8. CLCC de Haute Normandie Henri Becquerel, Rue d’Amiens, 76000, Rouen, France

    Chantal Henzen & Fernand Missohou

  9. CLCC Eugène Marquis, Rue de la Bataille Flandres-Dunkerque—CS 44229, 35042, Rennes Cedex, France

    Renaud de Crevoisier

  10. CLCC Antoine Lacassagne, 227, Avenue de la Lanterne, 06200, Nice, France

    Pierre Yves Bondiau

  11. Clinique de Courlancy, 38, Rue de Courlancy, 51100, Reims, France

    Philippe Collin

  12. CLCC Georges-François Leclerc, 1, Rue du Professeur Marion—BP 1544, 21034, Dijon Cedex, France

    Gilles Truc

  13. CLCC Val d’Aurelle-Paul Lamarque, 208, Rue des Apothicaires, 34298, Montpellier Cedex 5, France

    Christine Kerr

  14. CLCC Alexis Vautrin, Avenue de Bourgogne Brabois, 54511, Vandoeuvre-Lès-Nancy Cedex, France

    Valérie Bernier

  15. CHR Pasteur, 39, Avenue de la Liberté, 68000, Colmar, France

    David Atlani

  16. CHU Lyon Sud, 165, Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France

    Anne D’Hombres

  17. CLCC Paul Papin, 2, Rue Moll, 49933, Angers Cedex 9, France

    Sandrine Vinchon-Petit

  18. CHU Henri Mondor, 51, Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France

    Jean Léon Lagrange

  19. Service de Neurologie CHU Brabois, 54000, Nancy, France

    Luc Taillandier

Authors
  1. Georges Noel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aymeri Huchet
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Loic Feuvret
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean Philippe Maire
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pierre Verrelle
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Emilie Le Rhun
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maud Aumont
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. François Thillays
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Marie Pierre Sunyach
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Chantal Henzen
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Fernand Missohou
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Renaud de Crevoisier
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Pierre Yves Bondiau
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Philippe Collin
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Xavier Durando
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Gilles Truc
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Christine Kerr
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Valérie Bernier
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Jean-Baptiste Clavier
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. David Atlani
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Anne D’Hombres
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Sandrine Vinchon-Petit
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Jean Léon Lagrange
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Luc Taillandier
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Georges Noel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Noel, G., Huchet, A., Feuvret, L. et al. Waiting times before initiation of radiotherapy might not affect outcomes for patients with glioblastoma: a French retrospective analysis of patients treated in the era of concomitant temozolomide and radiotherapy. J Neurooncol 109, 167–175 (2012). https://doi.org/10.1007/s11060-012-0883-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-012-0883-7

Keywords

Search

Navigation