Schükkman, T. von (Tim) (2013) Glioblastomen in de dagelijkse praktijk. Een retrospectief onderzoek naar de behandeling vóór en na de introductie van temolozomide. thesis, Medicine.
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Abstract
The standard-of-care treatment for newly diagnosed cases of glioblastoma multiforme was changed in 2005 when neurosurgery and radiotherapy were augmented with the introduction of temozolomide (Temodal). The extent of improvement in patient survival due to this change is not yet clear in the setting of routine daily practice, where patients are not selected based on strict in- and exclusioncriteria commonly found in trials. All glioblastoma patients who were diagnosed and treated between 1998-2013 in the Isala Klinieken, a large non-academic hospital, were retrospectively evaluated to compare the periods before and after the introduction of temozolomide. This was done using Kaplan-Meier curves and the construction of a Cox ‘proportional hazards’ model. 50 patients were identified in the period between 1998-2003 and 122 patients in the period 2005-2013, for whom the median survival was 10,7 and 10,1 months respectively. Although the median survivals were comparable, the survival curves show a significant improvement of survival in the longer run. Since the introduction of temozolomide the median survival has become 13,3 months for the subgroup of patients who start with the temozolomide schedule and 34,0 months for the patients who are able to finish it. Still, the expected survival of an unselected population remains well under a year, mostly because a proportion of glioblastoma patients are not fit enough to begin chemotherapy. With these new data on survival of patients in the different phases of treatment, we can better estimate the expected survival for newly diagnosed patients. This study was also an opportunity to investigate prognostic factors influencing survival in glioblastoma patients and to evaluate the different possible treatments for recurrent glioblastoma.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | A. Otten and Isala Klinieken Zwolle and Neurologie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:55 |
| Last Modified: | 25 Jun 2020 10:55 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1551 |
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