The prognosis of recurrent glioblastoma (GB) is poor. The median survival with the Stupp protocol after progression is 3-6 months. After the implementation of a Neuro-Committee (CNON) in our center, second treatment options have changed life expectancy without reducing the quality of life.
Objectives: Show the selection criteria for second-line treatments in GB. Show overall survival (OS) for each treatment group.
We selected 18 patients with recurrent GB treated with surgery + radiotherapy + chemotherapy according Stupp protocol, between January 2010 and December 2013. After assessing the results in CNON, we differenciate two groups: Group 1 (n = 8), Patients who underwent surgical re-intervention + Carmustine implant polymers vs Group 2 (n = 10) those who could not benefit from surgery and received bevacizumab + Irinotecan. We analyzed 20 variables in each patient.
In the Group 1 median OS was 10 months (CI 95%: 4,762-15.238), and the PFS was 8 months (CI 95% 5,228-10,772). In the Group 2 median OS was 35.15 months (CI 95%, 17.219 -53.081) and the FPS was 20 months (CI 95% 0 - 40.144 months). In both groups morbidity and toxicity were acceptable and the quality of life was no affected.
Since the establishment by the CNON of a protocol for monitoring and second-line treatment in patients with GB, the overall survival has increased significantly. Of the two options presented, it seems more benefit treatment with Avastin + irinotecan and although the sample size is small, we should think in the adoption of more aggressive therapeutic options in the future.
Clinical trial identification
All authors have declared no conflicts of interest.