title: Age, Neurological Status MRC Scale, and Postoperative Morbidity are Prognostic Factors in Patients with Glioblastoma Treated by Chemoradiotherapy.
abstract: BACKGROUND
  Temozolomide and concomitant radiotherapy followed by temozolomide has been used as a standard therapy for the treatment of newly diagnosed glioblastoma multiform since 2005. A search for prognostic factors was conducted in patients with glioblastoma routinely treated by this strategy in our institution.
  
  
  METHODS
  This retrospective study included all patients with histologically proven glioblastoma diagnosed between June 1, 2005, and January 1, 2012, in the Franche-Comté region and treated by radiotherapy (daily fractions of 2 Gy for a total of 60 Gy) combined with temozolomide at a dose of 75 mg/m(2) per day, followed by six cycles of maintenance temozolomide (150-200 mg/m(2), five consecutive days per month). The primary aim was to identify prognostic factors associated with overall survival (OS) in this cohort of patients.
  
  
  RESULTS
  One hundred three patients were included in this study. The median age was 64 years. The median OS was 13.7 months (95% confidence interval, 12.5-15.9 months). In multivariate analysis, age over 65 years (hazard ratio [HR] = 1.88; P = 0.01), Medical Research Council (MRC) scale 3-4 (HR = 1.62; P = 0.038), and occurrence of postoperative complications (HR = 2.15; P = 0.028) were associated with unfavorable OS.
  
  
  CONCLUSIONS
  This study identified three prognostic factors in patients with glioblastoma eligible to the standard chemotherapy and radiotherapy treatment. Age over 65 years, MRC scale 3-4, and occurrence of postoperative complications were associated with unfavorable OS. A simple clinical evaluation including these three factors enables to estimate the patient prognosis. MRC neurological scale could be a useful, quick, and simple measure to assess neurological status in glioblastoma patients.
authors: Department of Neurology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Clotilde
authors: C
authors: Verlut
authors: Department of Medical Oncology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Guillaume
authors: G
authors: Mouillet
authors: Department of Neurology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Eloi
authors: E
authors: Magnin
authors: Department of Radiation Oncology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Joëlle
authors: J
authors: Buffet-Miny
authors: Department of Pathology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Gabriel
authors: G
authors: Viennet
authors: Department of Radiology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Françoise
authors: F
authors: Cattin
authors: Department of Radiology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Nora Clelia
authors: NC
authors: Billon-Grand
authors: Department of Radiation Oncology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Emilie
authors: E
authors: Bonnet
authors: Department of Radiation Oncology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Stéphanie
authors: S
authors: Servagi-Vernat
authors: Department of Neurosurgery, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Joël
authors: J
authors: Godard
authors: Department of Neurosurgery, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Romain
authors: R
authors: Billon-Grand
authors: Department of Neurosurgery, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Antoine
authors: A
authors: Petit
authors: Department of Neurology, University Hospital Jean Minjoz, Besançon cedex, France.; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France.
authors: Thierry
authors: T
authors: Moulin
authors: Department of Medical Oncology, University Hospital Jean Minjoz, Besançon cedex, France.
authors: Laurent
authors: L
authors: Cals
authors: Department of Medical Oncology, University Hospital Jean Minjoz, Besançon cedex, France.; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France.; INSERM UMR1098, Besançon, France.
authors: Xavier
authors: X
authors: Pivot
authors: Department of Medical Oncology, University Hospital Jean Minjoz, Besançon cedex, France.; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France.; INSERM UMR1098, Besançon, France.
authors: Elsa
authors: E
authors: Curtit
keywords: MRC neurological status; chemoradiotherapy; glioblastoma; temozolomide