Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany.
Department of Radiation Oncology, Martin-Luther-University, Halle (Saale), Germany.
J Cancer Res Clin Oncol. 2021 Nov;147(11):3381-3390. doi: 10.1007/s00432-021-03596-5. Epub 2021 Mar 20.
Glioblastoma multiforme (GBM) is a primary malignant brain tumour characterized by a very low long-term survival. The aim of this study was to analyse the distribution of treatment modalities and their effect on survival for GBM cases diagnosed in Germany between 1999 and 2014.
Cases were pooled from the German Cancer Registries with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes for GBM or giant-cell GBM. Three periods, first (January 1999-December 2005), second (January 2006-December 2010) and a third period (January 2011-December 2014) were defined. Kaplan-Meier plots with long-rank test compared median overall survival (OS) between groups. Survival differences were assessed with Cox proportional-hazards models adjusted for available confounders.
In total, 40,138 adult GBM cases were analysed, with a mean age at diagnosis 64.0 ± 12.4 years. GBM was more common in men (57.3%). The median OS was 10.0 (95% CI 9.0-10.0) months. There was an increase in 2-year survival, from 16.6% in the first to 19.3% in the third period. When stratified by age group, period and treatment modalities, there was an improved median OS after 2005 due to treatment advancements. Younger age, female sex, surgical resection, use of radiotherapy and chemotherapy, were independent factors associated with better survival.
The inclusion of temozolomide chemotherapy has considerably improved median OS in the older age groups but had a lesser effect in the younger age group of cases. The analysis showed survival improvements for each treatment option over time.
多形性胶质母细胞瘤（GBM）是一种原发性恶性脑肿瘤，其长期生存极低。本研究旨在分析 1999 年至 2014 年间德国诊断的 GBM 病例的治疗方式分布及其对生存的影响。
从德国癌症登记处收集国际肿瘤疾病分类第 3 版（ICD-O-3）编码为 GBM 或巨细胞 GBM 的病例。定义了三个时期：第一期（1999 年 1 月至 2005 年 12 月）、第二期（2006 年 1 月至 2010 年 12 月）和第三期（2011 年 1 月至 2014 年 12 月）。采用 Kaplan-Meier 图和长期秩检验比较各组的中位总生存期（OS）。采用 Cox 比例风险模型调整可用混杂因素评估生存差异。
共分析了 40138 例成人 GBM 病例，诊断时的平均年龄为 64.0±12.4 岁。男性（57.3%）更为常见。中位 OS 为 10.0（95%CI 9.0-10.0）个月。2 年生存率从第一期的 16.6%上升到第三期的 19.3%。按年龄组、时期和治疗方式分层，2005 年后由于治疗进展，中位 OS 有所提高。年龄较小、女性、手术切除、放疗和化疗的应用是与生存改善相关的独立因素。
替莫唑胺化疗的纳入显著提高了老年组的中位 OS，但对年轻组的影响较小。分析表明，每种治疗选择的生存改善随着时间的推移而增加。
