The Assessment Of Clınıcal Outcomes And Prognostıc Factors In Glıoblastoma Patıents

Thesis Type: Expertise In Medicine

Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey

Approval Date: 2020

Thesis Language: Turkish




The aim of the study is the assessment of clinical outcomes and prognostic factors in glioblastoma patients treated in our clinic. One-hundred and sixty-nine glioblastoma patients treated with surgery+concurrent CRT included in our study. Data of patients were gathered from patient files and electronic databases of hospitals, retrospectively and proper statistical analysis applied. The mean follow-up was 19 months. Mean values for OS, PFS and, PPS were 20,5, 10,8, and, 8,9 months, respectively. The ratios for OS in 12 months and, 24 months were 68% and 31%. The 6 and, 12 months PFS and PPS ratios were 74%, 30% and 44%, 22%, respectively. KPS, extent of resection (EOR) and use of adjuvant TMZ were significant for OS in multivariate analysis. Similarly, KPS, EOR, use of adjuvant TMZ and PTV volume were significant for PFS on multivariate analysis. The presence of ASL at the end of RT affects the OS and PFS negatively. OS and PFS ratios, recurrence patterns and ASL incidence were similar between the RTOG and EORTC regimes and IMRT and 3D-CRT techniques. Dose-volume parameters (V3, V5, V10, V15, V20 ve V25, V30, V40, V60 Gy) related to higher post-treatment ASL ratios were defined. Threshold values for each of them were indicated. Salvage therapies for recurrent disease provide better survival for glioblastoma patients. Up to date, the survival of glioblastoma patients is reporting approximately 24 months in patients treated with modern techniques and proper salvage treatment approach. Lymphocyte sparing approach may be more effective for concurrent use of promising immunotherapeutic agents with RT.