title: Salvage therapy in patients with glioblastoma: is there any benefit?
abstract: BACKGROUND
  Survival after first-line therapy is poor for patients with glioblastoma. The role of second-line treatment for recurrent disease is controversial. The authors studied the outcome in a subset of patients with glioblastoma who were selected for an aggressive reintervention strategy at the time of progression. Their objectives were to improve patients' overall survival with sustained quality of life and to make comparisons with overall survival in unselected patients.
  
  
  METHODS
  Overall, 168 patients were eligible for retrospective analysis. Ninety patients received specific therapy for disease recurrence (reintervention group) by specific criteria.
  
  
  RESULTS
  In the reintervention group, promising median overall survival (mOS) results after diagnosis (61.5 weeks) and progression (33 weeks) were obtained. The progression-free survival (PFS) rate at 12 months and the overall survival rate were superior in the reintervention group (71% at 12 months and 32% at 24 months) compared with the total cohort (45% and 20%, respectively) and the standard group (15% and 5%, respectively). A matched-pair analysis (n = 46 in each group), with an mOS period of 65.5 versus 28.5 weeks, confirmed these data. Quality of life was stable or slightly improved during reinterventions in a subset of patients treated within clinical studies.
  
  
  CONCLUSIONS
  The majority of patients in the current series were treated with a reintervention strategy, which had an impact on PFS and mOS. A second resection, focal radiotherapy (in selected cases), and additional chemotherapeutic regimens should be considered for patients with recurrent glioblastoma.
authors.affiliation: Klinik und Poliklinik für Neurologie der Universität Regensburg im Bezirksklinikum, Regensburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hau
authors.forename: Ulrike
authors.initials: U
authors.lastname: Baumgart
authors.forename: Katharina
authors.initials: K
authors.lastname: Pfeifer
authors.forename: Anne
authors.initials: A
authors.lastname: Bock
authors.forename: Tanya
authors.initials: T
authors.lastname: Jauch
authors.forename: Jörg
authors.initials: J
authors.lastname: Dietrich
authors.forename: Klaus
authors.initials: K
authors.lastname: Fabel
authors.forename: Oliver
authors.initials: O
authors.lastname: Grauer
authors.forename: Caecilia
authors.initials: C
authors.lastname: Wismeth
authors.forename: Monika
authors.initials: M
authors.lastname: Klinkhammer-Schalke
authors.forename: Michael
authors.initials: M
authors.lastname: Allgäuer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuierer
authors.forename: Horst
authors.initials: H
authors.lastname: Koch
authors.forename: Juergen
authors.initials: J
authors.lastname: Schlaier
authors.forename: Winfried
authors.initials: W
authors.lastname: Ulrich
authors.forename: Alexander
authors.initials: A
authors.lastname: Brawanski
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bogdahn
authors.forename: Andreas
authors.initials: A
authors.lastname: Steinbrecher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009367:Neoplasm Staging; D011788:Quality of Life; D011879:Radiotherapy Dosage; D012086:Reoperation; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents