Cerebellar glioblastoma multiforme: a retrospective study of 28 patients at a single institution

Cerebellar glioblastoma multiforme (CGBM) is rare and its treatment is ill defined. To elucidate prognostic factors, we performed a single institutional review of the largest series to date of CGBM. The West China Hospital database was reviewed from 2007 to June 2011, and a total of 28 CGBM patients were collected. Median age of patients was 50 years old, whereas median Karnofsky Performance Status was 80 (range, 30-100). Brainstem invasion was observed in 9 patients. Sixteen patients received total resection and 12 patients received subtotal resection. Postoperative Gamma Knife radiosurgery (GKRS) was administered to 22 patients. After operation, 16 patients received concurrent GKRS and chemotherapy, and 6 patients received chemotherapy after GKRS. In addition, 4 patients only received chemotherapy, and 2 patients did not receive either GKRS or chemotherapy due to various reasons. Median follow-up period was 13.7 months (range, 5.2-28.1 months). Median overall survival (OS) of 28 patients was 14.3 months and median progression-free survival (PFS) was 9.4 months. Univariate log-rank analysis showed that OS and PFS were significantly related to brainstem invasion (p = 0.03, p = 0.04, respectively), extent of resection (p = 0.02, p = 0.04, respectively) and GKRS (p = 0.01, p = 0.02, respectively) of GBM. Multivariate analysis revealed that OS and PFS were also significantly associated with brainstem invasion (p = 0.007, p = 0.014, respectively), extent of resection (p = 0.032, p = 0.045, respectively) and GKRS (p = 0.031, p = 0.046, respectively) of CGBM. According to our study, brainstem invasion, extent of resection and GKRS were major prognostic factors for survival. Combination of postoperative GKRS and chemotherapy had an improved prognosis, and it may be a feasible postoperative adjuvant treatment of CGBM.