Clinical, Therapeutic, and Prognostic Experience in Patients With Glioblastoma

Michel Mondragon-Soto; Luis A Rodríguez-Hernández; Sergio Moreno Jiménez; Juan Luis Gómez Amador; Axayacatl Gutierrez-Aceves; Humberto Montano-Tello; Ignacio Reyes-Moreno; Jose Santos-Zambrano; Elvira Castro-Martinez; Alberto Gonzalez-Aguilar

doi:10.7759/cureus.29856

Clinical, Therapeutic, and Prognostic Experience in Patients With Glioblastoma

Cureus. 2022 Oct 3;14(10):e29856. doi: 10.7759/cureus.29856. eCollection 2022 Oct.

Affiliations

¹ Neurological Surgery, Instituto Nacional de Neurologia y Neurocirugia, Tlalpan, MEX.
² Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
³ Neurological Surgery, American British Cowdray (ABC) Medical Center, México City, MEX.
⁴ Neurocirugía, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
⁵ Neuroradiosurgery, Neurology and Neurosugery National Institute, Mexico City, MEX.
⁶ Neurology, Instituto Nacional de Neurologia y Neurocirugia, Ciudad de Mexico, MEX.
⁷ Neuroradiosurgery, Neurology and Neurosurgery National Institute, Mexico City, MEX.
⁸ Neurology, Neurology and Neurosurgery National Institute, Mexico City, MEX.
⁹ Neurology, Gea Gonzalez Hospital, Mexico City, MEX.
¹⁰ Neurooncology, Neurology and Neurosurgery National Institute, Mexico City, MEX.

Abstract

Background: Glioblastoma (GB) represents the most aggressive type of glioma with a poor prognosis despite the therapies used. As of today, data availability for therapeutic and prognosis experiences is limited. The cornerstone for this study is to create a framework overview of Mexico´s experience throughout 17 years of research.

Methods: Retrospective analysis from 2000 to 2017 including patients with a histological diagnosis of GB was performed. Data were collected from the ABC Medical Center and the Neurology and Neurosurgery National Institute.

Results: One hundred and thirty-seven patients were included with a mean age of 54 years. Histological diagnosis was made in all patients, of which 58.1% had a total resection, 31.6% had a partial resection, and 10.3% of them underwent biopsy. In all cases, patients received treatment under the following conditions: 10 patients were treated exclusively with stereotactic radiotherapy (RT). In 55 patients, a combination of RT and TMZ was used, the other 40 patients received RT plus CBP. Eighteen patients RT added to nitrosourea medication and lastly, 14 patients received a combination of RT/TMZ and Bevacizumab, a monoclonal antibody that inhibits the formation of blood vessels (BVZ). The progression-free survival (PFS) and overall survival (OS) were higher in the RT/TMZ/BVZ group (16.5 to 22.9 months) and the RT/TMZ group (11 to 17 months), the prognostic parameters included: Isocitrate dehydrogenase 1 mutation (IDH1), usage of BVZ and TMZ in the PLS and OS, considering as well, age range (<70 years) as a favorable prognostic factor.

Conclusions: GB represents the most frequent intracranial neoplasia. Combined fractionated stereotactic RT added to Temozolomide and Bevacizumab received in our population reports favorable and superior results compared to the ones described in the literature. Further studies are necessary to know the biological behavior of our population.

Keywords: brain tumors (primary or brain metastasis); glioblastoma; neurologic complication of cancer or immunotherapy (cart); radiotherapy; survival; therapy.