title: Treatment results of glioblastoma during the last 30 years in a single institute.
abstract: Treatment results of glioblastoma (GB) during the last 30 years in Tohoku University were analyzed to identify any improvements in patient outcome in all 332 histologically proven cases of newly diagnosed GB treated consecutively in our department between 1982 and 2011. These 30 years was divided into 5 treatment eras, Group 1 (1982-1988, without preoperative evaluation by magnetic resonance [MR] imaging, n = 46), Group 2 (1989-1996, with preoperative MR imaging, n = 41), Group 3 (1997-1999, additionally underwent intraoperative functional brain mapping and neuronavigation system, n = 38), Group 4 (2000-August 2006, underwent 30 Gy of whole brain radiation followed by 30 Gy of extended local accelerated hyperfractionated radiation therapy, n = 96), and Group 5 (September 2006-2011, adjuvant usage of temozolomide [TMZ], n = 111). Overall survival (OS) was calculated from the date of surgery to the death from any cause. The median survival time/2-year OS/5-year OS of Groups 1 to 5 were 10.7 months/10.9%/0%, 17.3 months/26.2%/6.9%, 15.9 months/23.7%/5.3%, 20.1 months/34.8%/15.5%, and 20.9 months/45.5%/19.7%. The prognosis for patients with GB improved significantly after the introduction of MR imaging. Younger GB, defined as patients aged below 60 years, or total tumor resection with all ages in Group 5 had 5-year 0S of 31.0% and 30.1%, respectively. The prognosis of GB was improved significantly after the introduction of TMZ for elderly GB, recursive partitioning analysis class 5, or totally resected GB. Introduction of MR imaging and TMZ, and total resection of the tumor were important in the improvement of outcome for patients with GB.
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kumabe
authors.forename: Ryuta
authors.initials: R
authors.lastname: Saito
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanamori
authors.forename: Masashi
authors.initials: M
authors.lastname: Chonan
authors.forename: Yui
authors.initials: Y
authors.lastname: Mano
authors.forename: Ichiyo
authors.initials: I
authors.lastname: Shibahara
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kato
authors.forename: Yoji
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Sonoda
authors.forename: Jun
authors.initials: J
authors.lastname: Kawagishi
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Jokura
authors.forename: Mika
authors.initials: M
authors.lastname: Watanabe
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Katakura
authors.forename: Takamasa
authors.initials: T
authors.lastname: Kayama
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003399:Craniotomy; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000706:statistics & numerical data; D015376:Nimustine / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D015376:Nimustine; D003606:Dacarbazine; D000077204:Temozolomide