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Waiting time to radiotherapy as a prognostic factor for glioblastoma patients in a scenario of medical disparities / Tempo de espera para a radioterapia como um fator prognóstico em pacientes com glioblastoma em um cenário de disparidades médicas
Loureiro, Luiz Victor Maia; Pontes, Lucíola de Barros; Callegaro-Filho, Donato; Koch, Ludmila de Oliveira; Weltman, Eduardo; Victor, Elivane da Silva; Santos, Adrialdo José; Borges, Lia Raquel Rodrigues; Segreto, Roberto Araújo; Malheiros, Suzana Maria Fleury.
  • Loureiro, Luiz Victor Maia; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Pontes, Lucíola de Barros; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Callegaro-Filho, Donato; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Koch, Ludmila de Oliveira; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Weltman, Eduardo; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Victor, Elivane da Silva; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Santos, Adrialdo José; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Borges, Lia Raquel Rodrigues; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Segreto, Roberto Araújo; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Malheiros, Suzana Maria Fleury; Hospital Israelita Albert Einstein. Sao Paulo. BR
Arq. neuropsiquiatr ; 73(2): 104-110, 02/2015. tab, graf
Article in English | LILACS | ID: lil-741183
ABSTRACT
Objective To evaluate the effect of waiting time (WT) to radiotherapy (RT) on overall survival (OS) of glioblastoma (GBM) patients as a reliable prognostic variable in Brazil, a scenario of medical disparities. Method Retrospective study of 115 GBM patients from two different health-care institutions (one public and one private) in Brazil who underwent post-operative RT. Results Median WT to RT was 6 weeks (range, 1.3-17.6). The median OS for WT ≤ 6 weeks was 13.5 months (95%CI , 9.1-17.9) and for WT > 6 weeks was 14.2 months (95%CI, 11.2-17.2) (HR 1.165, 95%CI 0.770-1.762; p = 0.470). In the multivariate analysis, the variables associated with survival were KPS (p < 0.001), extent of resection (p = 0.009) and the adjuvant treatment (p = 0.001). The KPS interacted with WT to RT (HR 0.128, 95%CI 0.034-0.476; p = 0.002), showing that the benefit of KPS on OS depends on the WT to RT. Conclusion No prognostic impact of WT to RT could be detected on the OS. Although there are no data to ensure that delays to RT are tolerable, we may reassure patients that the time-length to initiate treatment does not seem to influence the control of the disease, particularly in face of other prognostic factors. .
RESUMO
Objetivo Avaliar o efeito do tempo de espera (TE) até radioterapia na sobrevida global de pacientes com glioblastoma como um fator prognóstico confiável. Método Estudo retrospectivo de 115 pacientes com glioblastoma, que foram submetidos à radioterapia pós-operatória, em dois serviços diferentes no Brasil (um público e outro privado). Resultados Mediana de TE para radioterapia foi de 6 semanas (variação, 1,3-17,6). A mediana de sobrevida para TE ≤ 6 semanas foi de 13,5 meses (IC95%, 9,1-17,9) e para TE > 6 semanas foi de 14,2 meses (IC95%, 11,2-17,2) (HR 1,165, 0,770-1,762; p = 0,470). Na análise multivariada, as variáveis associadas à sobrevida foram perfomance status (p < 0,001), extensão da ressecção (p = 0,009) e tratamento adjuvante (p = 0,001). Conclusão Não se observou impacto prognóstico para TE até a radioterapia na sobrevida. Diante de outros fatores prognósticos, é possível assegurar de que o espaço de tempo até a radioterapia não parece influenciar o controle da doença. .
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Papio / Uterine Contraction / Pregnancy, Animal Type of study: Observational study / Prognostic study / Risk factors Limits: Animals / Pregnancy Language: English Journal: Arq. neuropsiquiatr Journal subject: Neurology / Psychiatry Year: 2015 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Israelita Albert Einstein/BR

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Full text: Available Index: LILACS (Americas) Main subject: Papio / Uterine Contraction / Pregnancy, Animal Type of study: Observational study / Prognostic study / Risk factors Limits: Animals / Pregnancy Language: English Journal: Arq. neuropsiquiatr Journal subject: Neurology / Psychiatry Year: 2015 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Israelita Albert Einstein/BR