Patterns of care and survival of Chinese glioblastoma patients in the temozolomide era: a Hong Kong population-level analysis over a 14-year period
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AbstractBackground
The aim of this study is to address the paucity of epidemiological data regarding the characteristics, treatment patterns and survival outcomes of Chinese glioblastoma patients.
Methods
This was a population-level study of Hong Kong adult (>18 years) Chinese patients with newly diagnosed histologically confirmed glioblastoma between 2006 and 2019. The age standardized incidence rate (ASIR), patient-, tumor- treatment-related characteristics, overall survival (OS) as well as its predictors were determined.
Results
One thousand and ten patients with a median follow-up of 10.0 months were reviewed. The ASIR of glioblastoma was 1.0 per 100 000 population with no significant change during the study period. The mean age was 57 + 14 years. The median OS was 10.6 months (IQR: 5.2–18.4). Independent predictors for survival were: Karnofsky performance score >80 (adjusted OR: 0.8; 95% CI: 0.6–0.9), IDH-1 mutant (aOR: 0.7; 95% CI: 0.5–0.9) or MGMT methylated (aOR: 0.7; 95% CI: 0.5–0.8) glioblastomas, gross total resection (aOR: 0.8; 95% CI: 0.5–0.8) and temozolomide chemoradiotherapy (aOR 0.4; 95% CI: 0.3–0.6). Despite the significant increased administration of temozolomide chemoradiotherapy from 39% (127/326) of patients in 2006–2010 to 63% (227/356) in 2015–2019 (P-value < .001), median OS did not improve (2006–2010: 10.3 months vs 2015–2019: 11.8 months) (OR: 1.1; 95% CI: 0.9–1.3).
Conclusions
The incidence of glioblastoma in the Chinese general population is low. We charted the development of neuro-oncological care of glioblastoma patients in Hong Kong during the temozolomide era. Although there was an increased adoption of temozolomide chemoradiotherapy, a corresponding improvement in survival was not observed.
The aim of this study is to address the paucity of epidemiological data regarding the characteristics, treatment patterns and survival outcomes of Chinese glioblastoma patients.
Methods
This was a population-level study of Hong Kong adult (>18 years) Chinese patients with newly diagnosed histologically confirmed glioblastoma between 2006 and 2019. The age standardized incidence rate (ASIR), patient-, tumor- treatment-related characteristics, overall survival (OS) as well as its predictors were determined.
Results
One thousand and ten patients with a median follow-up of 10.0 months were reviewed. The ASIR of glioblastoma was 1.0 per 100 000 population with no significant change during the study period. The mean age was 57 + 14 years. The median OS was 10.6 months (IQR: 5.2–18.4). Independent predictors for survival were: Karnofsky performance score >80 (adjusted OR: 0.8; 95% CI: 0.6–0.9), IDH-1 mutant (aOR: 0.7; 95% CI: 0.5–0.9) or MGMT methylated (aOR: 0.7; 95% CI: 0.5–0.8) glioblastomas, gross total resection (aOR: 0.8; 95% CI: 0.5–0.8) and temozolomide chemoradiotherapy (aOR 0.4; 95% CI: 0.3–0.6). Despite the significant increased administration of temozolomide chemoradiotherapy from 39% (127/326) of patients in 2006–2010 to 63% (227/356) in 2015–2019 (P-value < .001), median OS did not improve (2006–2010: 10.3 months vs 2015–2019: 11.8 months) (OR: 1.1; 95% CI: 0.9–1.3).
Conclusions
The incidence of glioblastoma in the Chinese general population is low. We charted the development of neuro-oncological care of glioblastoma patients in Hong Kong during the temozolomide era. Although there was an increased adoption of temozolomide chemoradiotherapy, a corresponding improvement in survival was not observed.
All Author(s) ListWoo PYM, Yau S, Lam TC, Pu JKS, Li LF, Lui LCY, Chan DTM, Loong HHF, Lee MWY, Yeung R, Kwok CCH, Au SK, Tan TC, Kan ANC, Chan TKT, Mak CHK, Mak HKF, Ho JMK, Cheung KM, Tse TPK, Lau SSN, Chow JSW, El-Helali A, Ng HK, Poon WS
Journal nameNEURO-ONCOLOGY PRACTICE
Year2023
Month2
Volume Number10
Issue Number1
PublisherOXFORD UNIV PRESS
Pages50 - 61
ISSN2054-2577
eISSN2054-2585
LanguagesEnglish-United Kingdom
Keywordsage standardized incidence rate, Chinese, glioblastoma, overall survival, temozolomide chemoradiotherapy
Web of Science Subject CategoriesClinical Neurology;Neurosciences & Neurology
