Tujuan: Menilai kesintasan pasien Glioblastoma Multiform (GBM) di RSCM dan mengidentifikasi faktor-faktor yang dapat mempengaruhi kesintasan pasien dengan GBM. Metode: dilakukan studi retrospektif pada 55 pasien GBM yang terdiagnosa secara histopatologis dan menjalani radiasi/kemoradiasi di RSCM pada Januari 2015-Desember2019. Hasil: Mayoritas pasien adalah laki-laki dengan rasio 1,3:1 dibandingkanperempuan, rerata usia 45 tahun. Lokasi tumor tersering di lobus frontal (31,5%), lobuspariteal (26,3%) dan lobus temporal (24,2%). Median ekstensi reseksi tumor (EOR) 77%dan median volume residu tumor 50cm3. Median interval operasi-radiasi 42 hari denganmedian total dosis radiasi 60 Gy. 69,1% telah mendapatkan terapi sesuai dengan panduanpenatalaksanaan kanker (PPK). Median kesintasan hidup keseluruhan (OS) 13 bulan danmedian kesintasan bebas progresifitas (PFS) 9 bulan. Median OS pasien dengan RTOGRPA kelas III, kelas IV dan kelas V-VI adalah 18 bulan, 13 bulan dan 6,7 bulan (p<0,001).Faktor yang memperburuk OS adalah usia ≥50 tahun (p=0,02), KPS<70 (p<0,001),volume residu tumor >20,4cm3 (p=0,001), interval waktu operasi-radiasi <4minggu(p=0,01) dan letak tumor di lobus parietal (p=0,02) pada uji univariat. Faktor yangmemperburuk PFS adalah KPS <70 (p=0,001), volume residu tumor>20,4cm3 (p=0,02),terapi yang tidak sesuai PPK (p=0,004) dan letak tumor di lobus parietal (p=0,03). KPSmerupakan faktor independen yang mempengaruhi OS dan PFS pada uji multivariat.Kesimpulan: KPS merupakan faktor prognostik independen yang mempengaruhikesintasan pasien GBM.
Aims: This study was done to assess the survival of patients with glioblastoma multiformin RSCM and to identify factors that can affect patient survival. Materials and methods:From January 2015 to December 2019, 55 patients with histopathologically confirmedglioblastoma multiform and received adjuvant radiation/chemoradiation in ourdepartment were retrospectively analyzed. Results: Most of the patiens in this study weremen 1,3 times compared to women. Mean ages was 45 years old. The most commontumors site was frontal lobe (31,5%) followed by parietal lobe (26,3%) and temporal lobe(24,2%). Median extend of resection (EOR) was 77% with median residual tumor volumewas 50cm3. Most of the patients (69,1%) already treated according to practice guidelines.The median total radiation dose was 60Gy. Median time to initiate adjuvant radiotherapywas 42 days. Median overall survival (OS) was 13 months and median progression freesurvival (PFS) was 9 months. Median OS in patients with RTOG RPA class III, class IVand class V-VI were 18 months, 13 months and 6,7 months respectively (p<0,001).Age≥50 (p=0,02), KPS<70 (p<0,0001), residual tumor volume >20,4cm3 (p=0,001), timeto initiate adjuvant radiotherapy <4 weeks (p=0,01) and parietal lobes tumor site(p=0,02) were significantly associated with unfavorable OS in univariate analysis.KPS<70 (p=0,001), residual tumor volume >20,4cm3 (p=0,02), treatment that not inaccordance with practice guidelines (p=0,004) and parietal lobes tumor site (p=0,03)associated with unfavorable PFS in univariate analysis. KPS was found to be the onlyindependent factor that affected OS and PFS in multivariate analysis. Conclusions: Theonly factor that independently affected OS and PFS was KPS. |
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