Age, Neurological Status MRC Scale, and Postoperative Morbidity are Prognostic Factors in Patients with Glioblastoma Treated by Chemoradiotherapy

• Published in: Clinical Medicine Insights. Oncology Vol. 2016; no. 10; pp. 77 - 82
• Main Authors: Verlut, Clotilde, Mouillet, Guillaume, Magnin, Eloi, Buffet-Miny, Joëlle, Viennet, Gabriel, Cattin, Françoise, Billon-Grand, Nora Clelia, Bonnet, Emilie, Servagi-Vernat, Stéphanie, Godard, Joël, Billon-Grand, Romain, Petit, Antoine, Moulin, Thierry, Cals, Laurent, Pivot, Xavier, Curtit, Elsa
• Format: Journal Article Book Review
• Language: English
• Published: London, England Libertas Academica 01.01.2016; SAGE Publishing; SAGE Publications; Sage Publications Ltd; SAGE
• Subjects: Age; Brain cancer; Chemotherapy; Life Sciences; Medical prognosis; Original Research; Radiation therapy; temozolomide; MRC neurological status; chemoradiotherapy; glioblastoma
• ISSN: 1179-5549; 1179-5549
• DOI: 10.4137/CMO.S38474

Introduction: Temozolomide and concomitant radiotherapy followed by temozolomide has been used as a standard therapy for the treatment of newly diagnosed glioblastoma multiform since 2005. A search for prognostic factors was conducted in patients with glioblastoma routinely treated by this strategy in our institution. Methods: This retrospective study included all patients with histologically proven glioblastoma diagnosed between June 1, 2005, and January 1, 2012, in the Franche-Comté region and treated by radiotherapy (daily fractions of 2 Gy for a total of 60 Gy) combined with temozolomide at a dose of 75 mg/m^2 per day, followed by six cycles of maintenance temozolomide (150-200 mg/m^2, five consecutive days per month). The primary aim was to identify prognostic factors associated with overall survival (OS) in this cohort of patients. Results: One hundred three patients were included in this study. The median age was 64 years. The median OS was 13.7 months (95% confidence interval, 12.5-15.9 months). In multivariate analysis, age over 65 years (hazard ratio [HR] = 1.88; P = 0.01), Medical Research Council (MRC) scale 3-4 (HR = 1.62; P = 0.038), and occurrence of postoperative complications (HR = 2.15; P = 0.028) were associated with unfavorable OS. Conclusions: This study identified three prognostic factors in patients with glioblastoma eligible to the standard chemotherapy and radiotherapy treatment. Age over 65 years, MRC scale 3-4, and occurrence of postoperative complications were associated with unfavorable OS. A simple clinical evaluation including these three factors enables to estimate the patient prognosis. MRC neurological scale could be a useful, quick, and simple measure to assess neurological status in glioblastoma patients.