COMBINED AND MULTIMODAL TREATMENT FOR GLIOBLASTOMA PATIENTS USING INTRAOPERATIVE CHEMOTHERAPY
Objective. Evaluating the intraoperative Cisplacel chemotherapy efficacy in managing grade IV glioblastoma patients the criteria being the progression-free survival and overall survival values allowing for the prognostic factors.
Materials and methods. 445 patients with brain glioblastoma aged 16 to 78 years and Karnofsky performance status ³50% having received postoperative radio- or chemoradiotherapy with Temozolomide after surgical intervention,
51 (11.5%) of them having been administered intraoperative local Cisplacel chemotherapy.
Results. The uni- and multivariate analyses have demonstrated that intraoperative Cisplacel chemotherapy is an independent prognostic factor affecting the survival of patients enrolled in the study only when they age <54 years and there are no signs of a residual tumor after the surgical treatment. Cisplacel administration in this group of patients has made it possible achieve a statistically significant improvement of the median, 1-, 3- and 5-year progression-free survival from 12±1.08 months, 50.9±5.2%, 10.7±3.3%, and 9.2±3.2% to 25±7.04 months, 75.0±10.8%, 23.4±11.6%, and 23.4±11.6%, respectively (Р=0.032); and the median, 1-, 3- и 5-year overall survival from 18±1.27 months, 79.6±4.2%, 19.9±4.3%, and 9.9±3.3% to 35±14.10 months, 100±6.4%, 45.0±13.2%, and 23.5±11.3%, respectively (Р=0.048).
Conclusion. Intraoperative Cisplacel chemotherapy allows improve the treatment outcomes in glioblastoma patients aged <54 years having no signs of a residual tumor after a surgical treatment.