Prognostic factors and survival of glioblastoma multiform (GBM) in Iranian patients

Abstract

Background: Glioblastoma Multiform has been a common and fatal brain tumor. In this regard, there was ambiguity around patient survival rates in Iran que to data insufficiency. In this study, we have analyzed the overall and progression free survival in GBM patients at Milad Tehran hospital. Methods: In this retrospective study, wehave considered survival, clinical characteristics and prognostic factors in 123 primaryGBM patients who underwent surgical procedure (Biopsy or Resection) between February 2010 and June 2015 at Milad hospital, Tehran, Iran. All patients have pathologically proven as primary GBM. The overall survival and progression free survival has calculated using the Kaplan-Meier method. The Cox proportional hazards model has used for univariate analysis of prognostic factors. Age, gender, first symptom of the disease, tumor location and size, treatment protocol, and surgery have considered in the Cox model as prognostic factor. Results: One hundred and one patients have been studied. The mean age of the patients was 52.12 + 1.64, 67% of the patients were male, and 20% of the patients has not included in adjuvant therapy due to the patients low performance status after surgery. Patient median survival time was approximately 10.1 (6.3-11.8); 80% of the patient survive more than a month; and 57% of the patient has survived for six month, and one year survival of the patients was about 37%. Median progression free survival time was about 6.3 month, one-month progression free survival was 70%, and six months and one year progression free survival rates were 50% and 26%, respectively. Patients higher than 50 years have shown significant, 2 times more chance of death (HR = 2.00 CI 95% (1.3-3.2)) or disease progression (HR 1.94 CI 95% (1.3-3.2)). Correspondingly, patients who has not included in adjuvant therapy had 3.9 CI 95% (2.3-6.8) more hazard of death and 2.8 CI 95% (1.6-4.8) more chances of disease progression than who included in adjuvant therapy with TMZ and radiotherapy. Gender, symptom, tumor location or surgery type have not significantly affected patient prognosis. Conclusions: GBM patient’s survival would be quite poor. Nevertheless, this result was similar to the other reports from other centers and countries.