The influence of temozolomide on the survival of patients suffering from glioblastoma

Cilj istraživanja: Analiza rezultata učinka implementacije temozolomida u svakodnevnu kliničku praksu na liječenje (OS, PFS) bolesnika oboljelih od glioblastoma na Klinici za onkologiju i radioterapiju KBC Split od 2002. do 2004. godine i od 2009. do 2011. Prikaz epidemiologije glioblastoma na Klinici za onkologiju i radioterapiju KBC Split. Materijali i metode: U retrospektivnom istraživanju provedenom na Klinici za onkologiju i radioterapiju KBC Split prikupljeni su podatci o ukupno 113 bolesnika u dva razdoblja. Prikupljeni su opći podatci o bolesnicima i bolesti (dob u trenutku dijagnoze, vrsta operativnog zahvata, ustanova operativnog zahvata, ECOG status), podatci o modalitetu specifičnog onkološkog liječenja (kemoterapija, radioterapija), vrstama kemoterapijskih protokola (CCNU/vinkristin, temozolomid), odgovoru tumora na specifično onkološko liječenje, nuspojavama liječenja. Rezultati: Incidencija primarnih tumora mozga je u blagom smanjenju zadnjih 15-ak godina u Republici Hrvatskoj. U razdoblju od 2002. do 2004. godine zabilježeno je 4.75% slučajeva primarnih tumora mozga na Klinici za onkologiju i radioterapiju KBC Split. U razdoblju od 2009. do 2011. godine zabilježeno je 7.8% slučajeva primarnih tumora mozga. U oba razdoblja većina tih tumora su bili glioblastomi (56.33% naspram 67.27%). Broj bolesnika s glioblastomom koji su nakon operacije došli na liječenje na Kliniku za onkologiju i radioterapiju KBC Split se s godinama povećavao (40 bolesnika u prvom razdoblju naspram 73 u drugom razdoblju). Sekvencijski ordinirana radioterapija i kemoterapija je po dostupnosti temodala zamjenjena konkomitantnom kemoradioterapijom temozolomidom kao prvolinijskim liječenjem glioblastoma. Medijan preživljenja porastao je s 9 mjeseci iz prvoga razdoblja na 10 mjeseci u drugom razdoblju. Zaključci: Klinika za onkologiju i radioterapiju KBC Split, prateći vodeće onkološke smjernice, bilježi dobre rezultate u liječenju glioblastoma. Medijan ukupnog preživljenja od 9 mjeseci u prvom periodu te 10 mjeseci u drugome blizu je rezultata vodećih svjetskih ustanova u tim razdobljima. Uvođenje temozolomida 2007. godine na Kliniku za onkologiju i radioterapiju KBC Split imalo je skromni utjecaj na poboljšanje preživljenje bolesnika s glioblastomom. Povećao se broj bolesnika s glioblastomom liječenih u Klinici za onkologiju i radioterapiju KBC Split koji su operirani u drugim ustanovama.Objectives: The analysis of the results of the impact of implementation of temozolomide in everyday clinical practice in the treatment (OS, PFS) of patients with glioblastoma at the Department of Oncology and Radiotherapy, Clinical Hospital Split in the periods from 2002 to 2004 and from 2009 to 2011. A review of the epidemiology of glioblastoma at the Department of Oncology and Radiotherapy, Clinical Hospital Split. Material and methods: In a retrospective study conducted at the Department of Oncology and radiotherapy Clinical Hospital Split the data was collected on a total of 113 patients in both periods together. We colected general data on patients and the disease (age at diagnosis, type of surgery, hospital where the surgery was conducted, ECOG status), data about the specific modalities of cancer treatment (chemotherapy, radiotherapy), types of chemotherapy regimens (CCNU / vincristine, temozolomide), response on cancer-specific oncology treatment and side effects of the therapy. Results: There was a slight decline in the incidence of primary brain tumors in Croatia in the last 15 years. In the first period from 2002 to 2004 The Clinical Hospital Split recorded 4.75% of new cases of primary brain tumors and 7.8% in the second period from 2009 to 2011. In both periods the majority of these tumors were glioblastomas (56.33% and 67.27%). The number of patients who came for treatment at the Department of Oncology and Radiotherapy, Clical Hospital Split after surgery has increased over the years (40 patients in the first period versus 73 in the second period). Radiotherapy then chemotherapy was replaced by concomitant chemoradiotherapy with temozolomide as the first line therapy in newly diagnosed glioblastomas. The median of survival was increased from 9 months during the first period to 10 months in the second period. Conclusios: The Department of Oncology and Radiotherapy of the Clinical Hospital Split, Following the latest guidelines, recorded good results in the treatment of glioblastoma. The median overall survival of 9 months in the first period and 10 months in second period are near the results of the world's leading institutions in those periods. The introduction of temozolomide in the year 2007. at the Department of Oncology and Radiotherapy Clinical Hospital Split has had a modest impact on the treatment and survival of patients with glioblastoma. There was an increase in patients who came for specific oncological treatment for glioblastoma to the Department of Oncolgy Clinical Hospital Split over the years