title: Patterns of care and survival in a retrospective analysis of 1059 patients with glioblastoma multiforme treated between 2002 and 2007: a multicenter study by the Central Nervous System Study Group of Airo (italian Association of Radiation Oncology).
abstract: OBJECTIVE
  To investigate the pattern of care and outcomes for newly diagnosed glioblastoma in Italy and compare our results with the previous Italian Patterns of Care study to determine whether significant changes occurred in clinical practice during the past 10 years.
  
  
  METHODS
  Clinical, pathological, therapeutic, and survival data regarding 1059 patients treated in 18 radiotherapy centers between 2002 and 2007 were collected and retrospectively reviewed.
  
  
  RESULTS
  Most patients underwent both computed tomography and magnetic resonance imaging either preoperatively (62.7%) or postoperatively (35.5%). Only 123 patients (11.6%) underwent a biopsy. Radiochemotherapy with temozolomide was the most frequent adjuvant treatment (70.7%). Most patients (88.2%) received 3-dimensional conformal radiotherapy. Median survival was 9.5 months. Two- and 5-year survival rates were 24.8% and 3.9%, respectively. Multivariate analysis showed the statistical significance of age, postoperative Karnofsky Performance Status scale score, surgical extent, use of 3-dimensional conformal radiotherapy, and use of chemotherapy. Use of a more aggressive approach was associated with longer survival in elderly patients. Comparing our results with those of the subgroup of patients included in our previous study who were treated between 1997 and 2001, relevant differences were found: more frequent use of magnetic resonance imaging, surgical removal more common than biopsy, and widespread use of 3-dimensional conformal radiotherapy + temozolomide. Furthermore, a significant improvement in terms of survival was noted (P < .001).
  
  
  CONCLUSIONS
  Changes in the care of glioblastoma over the past few years are documented. Prognosis of glioblastoma patients has slightly but significantly improved with a small but noteworthy number of relatively long-term survivors.
authors.affiliation: Radioterapia, Università di Firenze, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy. silvia.scoccianti@unifi.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Scoccianti
authors.forename: Stefano Maria
authors.initials: SM
authors.lastname: Magrini
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
authors.forename: Beatrice
authors.initials: B
authors.lastname: Detti
authors.forename: Michela
authors.initials: M
authors.lastname: Buglione
authors.forename: Guido
authors.initials: G
authors.lastname: Sotti
authors.forename: Marco
authors.initials: M
authors.lastname: Krengli
authors.forename: Sergio
authors.initials: S
authors.lastname: Maluta
authors.forename: Salvatore
authors.initials: S
authors.lastname: Parisi
authors.forename: Filippo
authors.initials: F
authors.lastname: Bertoni
authors.forename: Cristina
authors.initials: C
authors.lastname: Mantovani
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tombolini
authors.forename: Costantino
authors.initials: C
authors.lastname: De Renzis
authors.forename: Marco
authors.initials: M
authors.lastname: Lioce
authors.forename: Lucia
authors.initials: L
authors.lastname: Fatigante
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fusco
authors.forename: Paolo
authors.initials: P
authors.lastname: Muto
authors.forename: Franco
authors.initials: F
authors.lastname: Berti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rubino
authors.forename: Samantha
authors.initials: S
authors.lastname: Cipressi
authors.forename: Laura
authors.initials: L
authors.lastname: Fariselli
authors.forename: Marco
authors.initials: M
authors.lastname: Lupattelli
authors.forename: Riccardo
authors.initials: R
authors.lastname: Santoni
authors.forename: Luigi
authors.initials: L
authors.lastname: Pirtoli
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Biti
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016208:Databases, Factual; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D005791:Patient Care; D011878:Radiotherapy; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis; D000077204:Temozolomide; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide