THE SURVIVAL OF GLIOBLASTOMA MULTIFORME PATIENTS AFTER BURR HOLE BIOPSY BASED ON THEIR POST BIOPSY TREATMENT WITH OR WITHOUT CHEMOTHERAPY AND OR RADIOTHERAPY

Abstract

INTRODUCTION: Maximal safe resection of high-grade glioma is the recommended standard of care and the outcomes following surgery and chemoradiotherapy are well described in the current era. However, for some patients only a biopsy is feasible or is their preference. It is essential to understand the outcomes in this cohort in order to support shared decision making and informed consent. OBJECTIVES: To study the survival of patients with biopsy only confirmed glioblastoma (GBM). METHODS: Retrospective series over a three year period (2012-14). All patients who underwent burr-hole biopsy for GBM were included. Median survival was calculated from the time of biopsy until the time of death. Patients were stratified according to post-biopsy treatment. RESULTS: 84 patients were identified. Significant complications resulting in death or disability did not occur in any patients. The median survival of 33 patients who received best supportive care after biopsy was 1.66 months (mean 1.96 SEM 0.24); for those 15 patients receiving radiotherapy alone was 4.66 months (mean 7.68 SEM 2.11); 10 patients with chemotherapy alone was 4.26 months (mean 9.16 SEM 2.59); and for those 25 patients who received chemoradiotherapy was 9.73 months (mean 11.36 SEM 1.30). CONCLUSION: There is obviously a selection bias, with younger patients in best performance status and with favourable molecular profiles being offered more radical treatment. Nonetheless, this study provides valuable information for the consent process and shared decision making to help specialists and patients understand the outcomes following biopsy alone with different forms of adjuvant treatment and to compare these outcomes with other options such as resection.