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Multimodal treatment of glioblastoma with multiple lesions - a multi-center retrospective analysis

  • 0Department of Neurosurgery, University Medical Center, Gutenberg University Mainz, Mainz, Germany. harald.krenzlin@unimedizin-mainz.de.
Journal of Neuro-Oncology +

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November 19, 2024

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November 19, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Multimodal treatment for glioblastoma with multiple lesions (ML) can achieve survival rates similar to solitary tumors. Aggressive maximal treatment, including extent of resection, is crucial for improving progression-free and overall survival in ML glioblastoma patients.

Area Of Science

  • Neuro-oncology
  • Surgical oncology
  • Radiation oncology

Background

  • Multiple localizations (ML) in glioblastoma are rare and often associated with a poor prognosis.
  • Effective treatment strategies for ML glioblastoma are crucial for improving patient outcomes.

Purpose Of The Study

  • To evaluate the impact of multimodal treatment on progression-free survival (PFS) and overall survival (OS) in glioblastoma with multiple lesions (ML).
  • To compare survival outcomes of ML glioblastoma patients treated with multimodal therapy versus those with solitary lesions.

Main Methods

  • Retrospective analysis of 134 patients with CNS WHO grade 4 glioblastoma with ML from two German neurosurgery departments (2008-2020).
  • Primary outcome measures included extent of resection (EOR) using 2021 RANO criteria, PFS, and OS.
  • Propensity score matching was used to compare ML patients with solitary lesion tumors.

Main Results

  • The extent of resection (EOR) was a significant predictor of PFS and OS in ML glioblastoma.
  • Complete, near-total, and subtotal resections significantly prolonged PFS and OS compared to biopsy alone.
  • Multimodal therapy, including radiotherapy and adjuvant treatment (Stupp protocol), significantly improved PFS and OS.
  • Propensity score matching revealed similar PFS and OS between patients with ML and solitary lesion glioblastomas (p=0.08).

Conclusions

  • Multimodal therapy can achieve survival rates comparable to solitary lesion glioblastomas in patients with ML.
  • Maximal treatment efforts, including aggressive surgical resection and adjuvant therapies, are vital for this patient group.
  • These findings underscore the importance of intensive treatment for glioblastoma with multiple lesions.

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