Influence of Residual Disease Following Surgical Resection in Newly Diagnosed Glioblastoma on Clinical, Neurocognitive, and Patient Reported Outcomes
العنوان: | Influence of Residual Disease Following Surgical Resection in Newly Diagnosed Glioblastoma on Clinical, Neurocognitive, and Patient Reported Outcomes |
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المؤلفون: | H. Ian Robins, Minesh P. Mehta, David Brachman, Jeffrey S. Wefel, Samuel T. Chao, Stephanie L. Pugh, Terri Armstrong, Paul D. Brown, Mark R. Gilbert, Merideth M Wendland, William A. Hall, Maria Werner-Wasik, Kevin S. Roof, Walter J. Curran, Benjamin Movsas |
المصدر: | Neurosurgery. 84:66-76 |
بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2018. |
سنة النشر: | 2018 |
مصطلحات موضوعية: | Adult, Male, Oncology, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Neoplasm, Residual, Bevacizumab, Word Association Tests, Antineoplastic Agents, Verbal learning, Placebo, Neurosurgical Procedures, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Internal medicine, Adjuvant therapy, Humans, Medicine, Young adult, Aged, Aged, 80 and over, MD Anderson Symptom Inventory - Brain Tumor, Trail Making Test, Brain Neoplasms, business.industry, Therapeutic effect, Recognition, Psychology, social sciences, Middle Aged, Verbal Learning, humanities, eye diseases, Treatment Outcome, Research—Human—Clinical Studies, 030220 oncology & carcinogenesis, Quality of Life, Female, Surgery, Self Report, Neurology (clinical), Glioblastoma, business, geographic locations, 030217 neurology & neurosurgery, medicine.drug |
الوصف: | Background The influence of subtotal resection (STR) on neurocognitive function (NCF), quality of life, and symptom burden in glioblastoma is unknown. If bevacizumab preferentially benefits patients with STR is unknown. Objective To examine these uncertainties. Methods NCF and patient reported outcomes (PRO) were prospectively collected in NRG Oncology RTOG 0525 and 0825. Changes in NCF and PRO measures from baseline to prespecified times were examined by Wilcoxon test, and mixed effects longitudinal modeling, to assess differences between patients who received STR vs gross-total resection. Changes were also compared among STR patients on 0825 receiving placebo vs bevacizumab to assess for a preferential therapeutic effect. Overall survival between STR and gross-total resection patients was compared using the Kaplan-Meier method. Results A total of 427 patients were eligible with STR present in 37%. At baseline, patients with STR had worse NCF, worse MD Anderson Symptom Inventory Brain Tumor Neurological Factor ratings (P = .004), and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (P = .002). Longitudinal multivariate analysis associated STR with worse NCF (Hopkins Verbal Learning Test-Revised Delayed Recognition [P = .048], Trail Making Test Part A [P = .035], and Controlled Oral Word Association [P = .049]). One hundred eighty-three STR patients from 0825 were analyzed (89 bevacizumab, 94 placebo); bevacizumab failed to demonstrate improvement in select NCF or PRO measures. Conclusion STR patients had worse NCF and PROs before therapy. During adjuvant therapy, STR patients had worse objective NCF, despite accounting for tumor location. STR did not result in a detriment to OS. The addition of bevacizumab did not preferentially improve PRO or NCF outcomes in STR patients. |
تدمد: | 1524-4040 0148-396X |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::caab7892b1306cebe221e65e2c2e4a7b https://doi.org/10.1093/neuros/nyy003 |
حقوق: | OPEN |
رقم الأكسشن: | edsair.doi.dedup.....caab7892b1306cebe221e65e2c2e4a7b |
قاعدة البيانات: | OpenAIRE |
تدمد: | 15244040 0148396X |
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