Second surgery for recurrent glioblastoma: A concise overview of the current literature

Montemurro, Nicola; Perrini, Paolo; Blanco, Magdalena Olivares; Vannozzi, Riccardo

doi:10.1016/j.clineuro.2016.01.010

Cited by 81 publications

(60 citation statements)

References 45 publications

(135 reference statements)

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“…Even in these patients, tumor progression is inevitable; at first progression, median progression-free survival (PFS) and median overall survival (OS) times typically reach 2-3 and 8-9 months, respectively (12). At progression, gross total resection can be achieved again in certain patients (13). Re-irradiation is also applied when technically possible (14).…”

Section: Introductionmentioning

confidence: 99%

Bevacizumab as a last-line treatment for glioblastoma following failure of radiotherapy, temozolomide and lomustine

et al. 2017

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Abstract. In previous trials, bevacizumab failed to prolong the overall survival time in newly diagnosed glioblastoma and at the first recurrence. Randomized clinical trials at the second or further recurrence following the failure of radiotherapy, temozolomide and lomustine, and retrospective analyses focusing on this specific cohort, are not yet available. A total of 62 patients with glioblastoma who received bevacizumab after the failure of standard care, including radiotherapy, temozolomide and lomustine, were retrospectively identified. Patient characteristics, previous treatment details, concomitant therapy, response based on the Response Assessment in Neuro-Oncology criteria, and progression-free survival (PFS) and overall survival (OS) times and rates were evaluated. Furthermore, the PFS and OS times and rates were analyzed for responders and non-responders. Of the patients, 54.8% (n=34) responded to treatment [complete response (CR) 3.2%, n=2; partial response (PR) 51.6%, n=32]. The median PFS time was 3.5 months and the median OS time was 7.5 months. The PFS rate at 6 months was 21.5% and the OS rate at 12 months was 11.5%. Responders (CR or PR) experienced a superior median PFS time compared with non-responders (i.e. stable or progressive disease; 5.4 vs. 1.9 months; P<0.0001) and a superior PFS rate at 6 months (34.9 vs. 7.1%; P<0.0001). The median OS time (8.6 vs. 6.4 months; P<0.0001) and OS rate at 12 months (21.3 vs. 0%; P<0.0001) were also superior in patients who exhibited a response to bevacizumab treatment. In conclusion, the objective response rate and the PFS and OS times and rates indicate that bevacizumab has activity in patients with glioblastoma following the failure of radiotherapy, temozolomide, and lomustine. A randomized trial comparing bevacizumab with best supportive care in these patients is advised.

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Section: Introductionmentioning

confidence: 99%

Bevacizumab as a last-line treatment for glioblastoma following failure of radiotherapy, temozolomide and lomustine

et al. 2017

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“…Although the consensus on the best treatment of recurrent disease is not as solid as with newly diagnosed disease, multiple retrospective studies support the excision of resectable recurrences. 17,19,28 However, with recurrent disease, issues of wound healing and the patient's functional status can hamper attempts of total resection. Moreover, recurrences often occur at sites close to functional or eloquent brain that were respected during the first surgery.…”

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confidence: 99%

Laser interstitial thermal therapy for newly diagnosed and recurrent glioblastoma

Thomas

Rao

Kew

et al. 2016

FOC

100

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OBJECTIVE Glioblastoma (GBM) is the most common and deadly malignant primary brain tumor. Better surgical therapies are needed for newly diagnosed GBMs that are difficult to resect and for GBMs that recur despite standard therapies. The authors reviewed their institutional experience of using laser interstitial thermal therapy (LITT) for the treatment of newly diagnosed or recurrent GBMs. METHODS This study reports on the pre-LITT characteristics and post-LITT outcomes of 8 patients with newly diagnosed GBMs and 13 patients with recurrent GBM who underwent LITT. RESULTS Compared with the group with recurrent GBMs, the patients with newly diagnosed GBMs who underwent LITT tended to be older (60.8 vs 48.9 years), harbored larger tumors (22.4 vs 14.6 cm3), and a greater proportion had IDH wild-type GBMs. In the newly diagnosed GBM group, the median progression-free survival and the median survival after the procedure were 2 months and 8 months, respectively, and no patient demonstrated radiographic shrinkage of the tumor on follow-up imaging. In the 13 patients with recurrent GBM, 5 demonstrated a response to LITT, with radiographic shrinkage of the tumor following ablation. The median progression-free survival was 5 months, and the median survival was greater than 7 months. CONCLUSIONS In carefully selected patients with recurrent GBM, LITT may be an effective alternative to surgery as a salvage treatment. Its role in the treatment of newly diagnosed unresectable GBMs is not established yet and requires further study.

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“…Surgical resection remains the rst-line therapy for recurrent GBM (rGBM). [7,8] Numerous studies have shown that some clinical characteristics, such as gross total resection (GTR) [7,9,10] and preoperative and postoperative KPS scores, were favorable factors for prolonged overall survival (OS) and progression-free survival in patients with rGBM. [10,11] However, there is limited information on prognostic factors for patients with sGBM.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and survival outcomes of secondary glioblastoma

Sun¹,

Li²,

Wang³

et al. 2020

Preprint

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Background Secondary glioblastoma (sGBM) is a specific, and prognostic factors of sGBM are still unclear. This study retrospectively investigated clinical prognosis factors of survival outcomes of sGBM.Methods All of 125 patients were recruited in this study. Clinical characteristics and survival outcomes were acquired from inpatient records and follow-ups. Kaplan‑Meier survival analysis and Cox survival analysis were applied to identifying prognostic factors.Results The median overall survival (OS) were 301 days. Gross total resection (GTR) (HR = 0.613, 95% confident interval (CI) = 0.408-0.923, p = 0.019), diagnosed sGBM without newly occurring symptoms when regular re-examination (DR) (HR= 0.481, 95% CI = 0.308-0.750, p = 0.001), higher postoperative Karnofsky Performance Status (KPS) score (HR = 0.977, 95% CI = 0.961-0.993, p = 0.006) were independently favorable prognosis factors for OS. GTR was the favorable factor for OS of sGBM patients of DR (HR = 0.238, 95% CI = 0.100-0.570, p = 0.001) and with new functional impairments (HR = 0.410, 95% CI = 0.205-0.821, p = 0.012). Additionally, postoperative KPS score not decreasing was the favorable factor for OS of sGBM patients with new functional impairments (HR = 0.401, 95% CI = 0.202-0.795, p = 0.009) and with new occurring epilepsy (HR = 0.295, 95% CI from 0.092 to 0.950, p = 0.041).Conclusions For patients with sGBM, GTR, higher postoperative KPS score, and diagnosed without newly occurring symptoms were favorable factors for the OS. The GTR was recommended for sGBM patients to improve survival outcomes.

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Second surgery for recurrent glioblastoma: A concise overview of the current literature

Cited by 81 publications

References 45 publications

Bevacizumab as a last-line treatment for glioblastoma following failure of radiotherapy, temozolomide and lomustine

Bevacizumab as a last-line treatment for glioblastoma following failure of radiotherapy, temozolomide and lomustine

Laser interstitial thermal therapy for newly diagnosed and recurrent glioblastoma

Clinical characteristics and survival outcomes of secondary glioblastoma

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