title: Improved survival time trends for glioblastoma using the SEER 17 population-based registries.
abstract: The EORTC/NCIC 22981/26981 study demonstrated an improvement in median overall survival (OS) from 12.1 to 14.6 months in patients with glioblastoma (GBM) who received temozolomide with post-operative radiotherapy (RT). The current study was performed to determine if those results translated into a survival benefit in a population-based cohort. Patients diagnosed between 2000 and 2006 with a GBM who underwent surgery and post-operative RT were selected from the Surveillance, Epidemiology and End Results database. Patients were grouped into time periods: 2000-2001, 2002-2003, 2004 and 2005-2006 (which represented those treated after the EORTC/NCIC trial presentation in 2004). Relative survival (RS) was estimated by the Kaplan-Meier method, and Cox multivariable regression modeling was used to estimate proportional hazard ratios (HR). Over time, there was improvement in the median and 2-year RS of 12 months and 15% for 2000-2001, 13 months and 19% for 2002-2003, 14 months and 24% for 2004, and 15 months and 26% for 2005-2006 (P < 0.0001 compared to 2000-2001 and 2002-2003; P = 0.07 compared to 2004). The estimated adjusted HR showed that patients diagnosed in 2005-2006 had significantly improved survival when compared to patients diagnosed in 2000-2001 (HR = 0.648, 95% CI 0.604-0.696). The median and 2 year RS of 15 months and 26% in 2005-2006 was similar to the median and 2 year OS of 14.6 months and 26% seen in the EORTC/NCIC phase III study. These results are encouraging and suggest that the current treatment of glioblastoma nationwide is now associated with an improved survival compared to previous time cohorts.
authors: Department of Radiation Oncology, University of Illinois at Chicago, Chicago, IL, USA. mkoshy@radonc.uchicago.edu
authors: Matthew
authors: M
authors: Koshy
authors: John L
authors: JL
authors: Villano
authors: Therese A
authors: TA
authors: Dolecek
authors: Andrew
authors: A
authors: Howard
authors: Usama
authors: U
authors: Mahmood
authors: Steven J
authors: SJ
authors: Chmura
authors: Ralph R
authors: RR
authors: Weichselbaum
authors: Bridget J
authors: BJ
authors: McCarthy
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D017326:Clinical Trials, Phase III as Topic; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D018426:SEER Program; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult