title: Patterns of care and outcome for patients with glioblastoma diagnosed during 2008-2010 in Spain.
abstract: BACKGROUND
  To assess management patterns and outcome in patients with glioblastoma multiforme (GBM) treated during 2008-2010 in Spain.
  
  
  METHODS
  Retrospective analysis of clinical, therapeutic, and survival data collected through filled questionnaires from patients with histologically confirmed GBM diagnosed in 19 Spanish hospitals.
  
  
  RESULTS
  We identified 834 patients (23% aged >70 years). Surgical resection was achieved in 66% of patients, although the extent of surgery was confirmed by postoperative MRI in only 41%. There were major postoperative complications in 14% of patients, and age was the only independent predictor (Odds ratio [OR], 1.03; 95% confidence interval [CI],1.01-1.05; P = .006). After surgery, 57% received radiotherapy (RT) with concomitant and adjuvant temozolomide, 21% received other regimens, and 22% were not further treated. In patients treated with surgical resection, RT, and chemotherapy (n = 396), initiation of RT ≤42 days was associated with longer progression-free survival (hazard ratio [HR], 0.8; 95% CI, 0.64-0.99; P = .042) but not with overall survival (HR, 0.79; 95% CI, 0.62-1.00; P = .055). Only 32% of patients older than 70 years received RT with concomitant and adjuvant temozolomide. The median survival in this group was 10.8 months (95% CI, 6.8-14.9 months), compared with 17.0 months (95% CI, 15.5-18.4 months; P = .034) among younger patients with GBM treated with the same regimen.
  
  
  CONCLUSIONS
  In a community setting, 57% of all patients with GBM and only 32% of older patients received RT with concomitant and adjuvant temozolomide. In patients with surgical resection who were eligible for chemoradiation, initiation of RT ≤42 days was associated with better progression-free survival.
authors: Service of Neurology, Hospital Clínic, Villarroel 170, Barcelona 08036, Spain. fgraus@clinic.ub.es
authors: Francesc
authors: F
authors: Graus
authors: Jordi
authors: J
authors: Bruna
authors: Javier
authors: J
authors: Pardo
authors: Domingo
authors: D
authors: Escudero
authors: Dolores
authors: D
authors: Vilas
authors: Inés
authors: I
authors: Barceló
authors: Marta
authors: M
authors: Brell
authors: Carmen
authors: C
authors: Pascual
authors: José A
authors: JA
authors: Crespo
authors: Elena
authors: E
authors: Erro
authors: Juan C
authors: JC
authors: García-Romero
authors: Jordi
authors: J
authors: Estela
authors: Juan
authors: J
authors: Martino
authors: Almudena
authors: A
authors: García-Castaño
authors: Elena
authors: E
authors: Mata
authors: Manuela
authors: M
authors: Lema
authors: Miguel
authors: M
authors: Gelabert
authors: Rafel
authors: R
authors: Fuentes
authors: Pedro
authors: P
authors: Pérez
authors: Arancha
authors: A
authors: Manzano
authors: Jesús
authors: J
authors: Aguas
authors: Antonio
authors: A
authors: Belenguer
authors: Ana
authors: A
authors: Simón
authors: Iván
authors: I
authors: Henríquez
authors: Mauricio
authors: M
authors: Murcia
authors: Rosa
authors: R
authors: Vivanco
authors: Iñigo
authors: I
authors: Rojas-Marcos
authors: David
authors: D
authors: Muñoz-Carmona
authors: Inmaculada
authors: I
authors: Navas
authors: Pablo
authors: P
authors: de Andrés
authors: Gemma
authors: G
authors: Mas
authors: Miguel
authors: M
authors: Gil
authors: Eugènia
authors: E
authors: Verger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D000077204:Temozolomide; D013997:Time Factors; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: glioblastoma multiforme; older patients; practice patterns; radiotherapy delay; surgical complications