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@ARTICLE{Stavrinou:873534,
      author       = {Stavrinou, Pantelis and Kalyvas, Aristotelis and Grau,
                      Stefan and Hamisch, Christina and Galldiks, Norbert and
                      Katsigiannis, Sotirios and Kabbasch, Christoph and Timmer,
                      Marco and Goldbrunner, Roland and Stranjalis, George},
      title        = {{S}urvival effects of a strategy favoring second-line
                      multimodal treatment compared to supportive care in
                      glioblastoma patients at first progression},
      journal      = {Journal of neurosurgery},
      volume       = {131},
      number       = {4},
      issn         = {1933-0693},
      address      = {Charlottesville, Va.},
      publisher    = {American Assoc. of Neurological Surgeons},
      reportid     = {FZJ-2020-00802},
      pages        = {1136 - 1141},
      year         = {2019},
      abstract     = {OBJECTIVEData on the survival effects of supportive care
                      compared to second-line multimodal treatment for
                      glioblastoma progression are scarce. Thus, the authors
                      assessed survival in two population-based, similar cohorts
                      from two European university hospitals with different
                      treatment strategies at first progression.METHODSThe authors
                      retrospectively identified patients with newly diagnosed
                      glioblastoma treated at two neurooncological centers. After
                      diagnosis, patients from both centers received identical
                      treatments, but at tumor progression each center used a
                      different approach. In the majority of cases, at center A
                      (Greece), supportive care or a single therapeutic modality
                      was offered at progression, whereas center B (Germany)
                      provided multimodal second-line therapy. The main outcome
                      measure was survival after progression (SaP). The influence
                      of the treatment strategy on SaP was assessed by
                      multivariate analysis.RESULTSOne hundred three patients from
                      center A and 156 from center B were included. Tumor
                      progression was observed in 86 patients (center A) and 136
                      patients (center B). At center A, 53 patients $(72.6\%)$
                      received supportive care alone, while at center B, 91
                      patients $(80.5\%)$ received second-line treatment.
                      Progression-free survival at both centers was similar (9.4
                      months [center A] vs 9.0 months [center B]; p = 0.97), but
                      SaP was significantly improved in the patients treated with
                      multimodal second-line therapy at center B (7 months, $95\%$
                      CI 5.3–8.7 months) compared to those treated with
                      supportive care or a single therapeutic modality at center A
                      (4.5 months, $95\%$ CI 3.5–5.5 months; p = 0.003). In the
                      multivariate analysis, the treatment center was an
                      independent prognostic factor for overall survival (HR 1.59,
                      $95\%$ CI 0.17–2.15; p = 0.002).CONCLUSIONSTreatment
                      strategy favoring multimodal second-line treatment over
                      minimal treatment or supportive care at glioblastoma
                      progression is associated with significantly better overall
                      survival.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30544353},
      UT           = {WOS:000490249600018},
      doi          = {10.3171/2018.7.JNS18228},
      url          = {https://juser.fz-juelich.de/record/873534},
}