Clinical Outcome of Postoperative Radiotherapy with or without Chemotherapy in Adult Glioblastoma Multiforme in Ramathibodi Hospital: A Retrospective Study
Parmon Puddhikarant MD*, Thiti Swangsilpa MD*, Mantana Dhanachai MD, MSc*, Ladawan Narkwong MD*, Chomporn Sitathanee MD*, Putipun Puataweepong MD, MSc*, Chuleeporn Jiarpinitnun MD*, Patamintita Witoonpanich MD*, Rawee Ruangkanchanasetr MD*
Affiliation : * Radiation Oncology Division, Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To identify the treatment outcome of glioblastoma multiforme (GBM) in Ramathibodi Hospital from overall
survival rate and related prognostic factors.
Material and Method: Medical records of patients with histological diagnosis of GBM treated at Radiation Oncology
Division, Radiology Department, Ramathibodi Hospital between 2000 and 2010 were reviewed and available data extracted
for evaluation of treatment outcome.
Results : There were 47 patients with mean age at diagnosis of 51.9 years (range from 18 to 82 years). Surgery (partial
76.6%, total 12.8%, and biopsy 10.6%) followed by postoperative radiotherapy (mean dose 52 gray) was the treatment of
choice with or without concurrent and adjuvant Temozolomide (TMZ). With median follow-up time of 0.9 years, the median
survival of the patients was 2.1 years (95% CI 1.08-7.36), whereas one and two-year overall survival rates were 78.0% and
57.8%, respectively. In univariate analysis, persistent neurological deficit after surgery and presenting symptom of visual
disturbance were identified to lower overall survival while multivariate analysis, younger age, and higher radiation dose
were identified as favorable prognostic factors to improve overall survival. Re-surgery or re-irradiation in some selected
cases of recurrent or progressive disease was considered as a choice for palliative treatment.
Conclusion : Proper management of GBM patient was surgical removal and postoperative radiotherapy with or without
chemotherapy. Proper palliative treatment modality was considered in selected cases of recurrent or progressive disease.
Keywords : Glioblastoma multiforme (GBM), Radiotherapy, Postoperative
