Abstract 305P
Background
Gliomas are brain tumours that develop from glial cells and the most common type is Glioblastoma (GBM). The initial standard treatment is the STUPP protocol. These patients (pts) are often previously submitted to surgery to remove the lesion. Its treatment is not curative and it will recur at some point. Treatment options in case of disease recurrence are chemotherapy (CT), surgery, radiotherapy (RT) and, in the case of poor performance status and advanced age, best supportive care (BSC). Some studies have compared treatments used in 2nd line of GBM but the results have been inconsistent. So, the aim of this study is to evaluate the association of surgery and CT in 2nd line treatment of GBM, comparing PFS and OS between pts exposed to CT, with and without surgery.
Methods
Evaluation of adult pts diagnosed with GBM recurrence after 1st line treatment, between January of 2018 and June of 2021, in two neuro-oncology centres. Comparison of outcomes obtained between pts exposed to CT who underwent surgery or not, in 2nd line. Statistical significance (p<0.05).
Results
One hundred and fifteen pts were evaluated, all with GBM IDH wt, mostly men (54.8%) and with good general status (ECOG PS 0 or 1 in 87.8%). The median age at diagnosis was 60 years. In the 99 pts who recurred after initial surgery and 1st line treatment, 46 (46,5%) were subsequently treated with only CT, while 38 (38.4%) were submitted to surgery followed by CT, of which complete removal was performed in 5 pts (13.2%). Overall, in pts undergoing CT as 2nd line, with or without surgery, the median PFS (PFS2) and OS was 5 months and 20 months, respectively. In pts undergoing surgery followed by CT, the median PFS2 and OS were 5 months and 24 months vs. 5 months and 18 months in pts undergoing only CT, an improved OS without statistical significance. Considering only pts who underwent surgery with complete removal, median PFS2 and OS was 9 and 48 months vs. 5 and 19 months in the remaining pts. In these pts, OS improvement was significant (p=0.048), a trend not observable when englobing also pts with subtotal resection.
Conclusions
This study showed a benefit in performing surgery at the OS level but not at the PFS level, without statistical significance. However, the median OS improves significantly when the resection is complete.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.