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Post-surgical therapeutic approaches to glioblastoma patients submitted to biopsy (BA) or “partial” resection (PR): the possibilities to treat also them without renunciations. Study from the Brescia Neuro-Oncology Group

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Abstract

The extent of surgery predicts overall survival (OS) in patients treated for glioblastoma (GBM). The therapeutic approach after partial resection (PR) or biopsy alone (BA) is not clearly defined. This retrospective analysis was therefore planned to analyse clinical features, treatment and survival of patients undergoing PR or BA. We analysed the clinical/therapeutic features and the outcome of 232 patients submitted to BA/PR and treated with radiotherapy (RT) with/without chemotherapy. Two subgroups (pre- and post-Temozolomide-era) were identified. The BA/PR ratio did not change with the accrual periods. In the TMZ-era, 50 % of the patients had chemotherapy; “small” volume, hypo-fractionated and “low” dose RT (<54 Gy) were delivered to 93, 38 and 44 % of the patients; corresponding values for the previous period were 4, 28, 11 and 2 % (P < 0.001). Better two-year OS was evident in the TMZ-era (18 vs 7 %); PR and chemotherapy affected OS in patients treated with hypo-fractionated, low doses RT (P = 0.02, 0.04). Limited volume, more often MRI-based, and “short” RT treatments were given mostly to unfavourably selected patients, without compromising the results of the whole group. This strategy, combined with an increased use of chemotherapy, resulted in reduced treatment burden, in an improved 2-year OS rate and prospectively in better quality of life, even in this prognostically worse subset of glioma patients.

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Conflict of interest

The authors report no declaration of conflict of interest concerning the materials and methods used in this study or the findings specified in this paper.

Ethical standards

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards”.

Informed consent

“For this type of study (retrospective), formal consent is not required”.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of Brescia, P.le Spedali Civili, 1, 25123, Brescia, BS, Italy

    Michela Buglione, Paolo Borghetti, Sara Pedretti, Luca Triggiani & Stefano Maria Magrini

  2. Department of Neurosurgery, University of Brescia, Brescia, Italy

    Marco Maria Fontanella & Giannantonio Spena

  3. Department of Medical Oncology, Spedali Civili Brescia, Brescia, Italy

    Salvatore Grisanti

  4. Department of Neuroradiology, University of Brescia, Brescia, Italy

    Roberto Liserre

  5. Department of Pathology, University of Brescia, Brescia, Italy

    Luigi Pietro Poliani

  6. Department of Neurology, University of Brescia, Brescia, Italy

    Stefano Gipponi

  7. Department of Medical Physics, Spedali Civili Brescia, Brescia, Italy

    Luigi Spiazzi

Authors
  1. Michela Buglione
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  2. Paolo Borghetti
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  3. Sara Pedretti
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  4. Luca Triggiani
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  5. Marco Maria Fontanella
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  6. Giannantonio Spena
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  7. Salvatore Grisanti
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  8. Roberto Liserre
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  9. Luigi Pietro Poliani
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  10. Stefano Gipponi
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  11. Luigi Spiazzi
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  12. Stefano Maria Magrini
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Corresponding author

Correspondence to Michela Buglione.

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Buglione, M., Borghetti, P., Pedretti, S. et al. Post-surgical therapeutic approaches to glioblastoma patients submitted to biopsy (BA) or “partial” resection (PR): the possibilities to treat also them without renunciations. Study from the Brescia Neuro-Oncology Group. Radiol med 120, 975–981 (2015). https://doi.org/10.1007/s11547-015-0528-y

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  • DOI: https://doi.org/10.1007/s11547-015-0528-y

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