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Delay in starting radiotherapy due to neoadjuvant therapy does not worsen survival in unresected glioblastoma patients

  • C. Balaña [1] ; A. Estival [1] ; I. Teruel [1] ; M. Hardy-Werbin [2] ; J. Sepulveda [11] ; E. Pineda [12] ; M. Martinez-García [3] ; O. Gallego [4] ; R. Luque [5] ; M. Gil-Gil [6] ; C. Mesia [6] ; S. Del Barco [13] ; A. Herrero [7] ; A. Berrocal [8] ; P. Perez-Segura [9] ; R. De las Penas [14] ; J. Marruecos [13] ; R. Fuentes [13] ; G. Reynes [10] ; J. M. Velarde [15] ; A. Cardona [16] ; E. Verger [12] ; C. Panciroli [15] ; S. Villà [1]
    1. [1] Hospital Universitari Germans Trias i Pujol

      Hospital Universitari Germans Trias i Pujol

      Barcelona, España

    2. [2] Institut Hospital del Mar d'Investigacions Mèdiques

      Institut Hospital del Mar d'Investigacions Mèdiques

      Barcelona, España

    3. [3] Hospital del Mar

      Hospital del Mar

      Barcelona, España

    4. [4] Hospital de la Santa Creu i Sant Pau

      Hospital de la Santa Creu i Sant Pau

      Barcelona, España

    5. [5] Hospital Universitario Virgen de las Nieves

      Hospital Universitario Virgen de las Nieves

      Granada, España

    6. [6] Institute Catalá Oncología

      Institute Catalá Oncología

      Barcelona, España

    7. [7] Hospital Miguel Servet

      Hospital Miguel Servet

      Zaragoza, España

    8. [8] Hospital General Universitario de Valencia

      Hospital General Universitario de Valencia

      Valencia, España

    9. [9] Hospital Clínico San Carlos de Madrid

      Hospital Clínico San Carlos de Madrid

      Madrid, España

    10. [10] Hospital Universitario La Fe

      Hospital Universitario La Fe

      Valencia, España

    11. [11] Hospital Universitario Madrid
    12. [12] Hospital Clinic Provincial, Barcelona
    13. [13] Hospital Josep Trueta, Girona
    14. [14] Hospital Provincial de Castellón
    15. [15] Hospital Germans Trias i Pujol
    16. [16] Clínica del Country, Bogotá, Colombia
  • Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 20, Nº. 12, 2018, págs. 1529-1537
  • Idioma: inglés
  • Texto completo no disponible (Saber más ...)
  • Resumen
    • Purpose We retrospectively examined the potential effect on overall survival (OS) of delaying radiotherapy to administer neoadjuvant therapy in unresected glioblastoma patients.

      Patients and methods We compared OS in 119 patients receiving neoadjuvant therapy followed by standard treatment (NA group) and 96 patients receiving standard treatment without neoadjuvant therapy (NoNA group). The MaxStat package of R identified the optimal cut-off point for waiting time to radiotherapy.

      Results OS was similar in the NA and NoNA groups. Median waiting time to radiotherapy after surgery was 13 weeks for the NA group and 4.2 weeks for the NoNA group. The longest OS was attained by patients who started radiotherapy after 12 weeks and the shortest by patients who started radiotherapy within 4 weeks (12.3 vs 6.6 months) (P = 0.05). OS was 6.6 months for patients who started radiotherapy before the optimal cutoff of 6.43 weeks and 19.1 months for those who started after this time (P = 0.005). Patients who completed radiotherapy had longer OS than those who did not, in all 215 patients and in the NA and NoNA groups (P = 0.000). In several multivariate analyses, completing radiotherapy was a universally favorable prognostic factor, while neoadjuvant therapy was never identified as a negative prognostic factor.

      Conclusion In our series of unresected patients receiving neoadjuvant treatment, in spite of the delay in starting radiotherapy, OS was not inferior to that of a similar group of patients with no delay in starting radiotherapy.


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