Significance of radiation therapy in frontal glioblastoma patients and exploration of optimal treatment modality: a real-world multiple-center study based on propensity score matching.

Abstract

Background: Glioblastoma (GBM) exhibits diffuse and invasive growth patterns, with a 5-year overall survival (OS) rate of 5-10%. In addition, approximately 40 percent of GBMs are localized in the frontal lobe, a region closely linked to essential life functions including cognition, so that it cannot be completely eradicated through surgical intervention, leading to very poor prognosis. Postoperative therapy is an essential treatment modality. The aim of this study is to explain the possible role of radiation therapy (RT) in the treatment of frontal GBM, providing more evidence for clinical application.

Methods: In the study, patient information pertaining to frontal GBM patients was collected from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2000 to 2018 with 9,904 patients deemed appropriate for inclusion in this study. A 1:2 propensity score matching analysis was conducted to balance the non-radiotherapy and radiotherapy group. This study is a retrospective study.

Results: Before matching, the median OS, tumor specific survival (TSS) and hazard ratio (HR) were 3 months, 3 months and 4.408 [95% confidence interval (CI): 3.762-4.535, P<0.001] in the non-RT group compared to those of 13 months, 14 months and 2.463 (95% CI: 2.247-2.936, P<0.001) in the RT group. After matching, the median OS, TSS and HR were 3 months, 4 months and 1.433 (95% CI: 1.387-1.692, P<0.001) in the non-RT group compared to those of 8 months, 8 months and 1.427 (95% CI: 1.374-1.682, P<0.001) in the RT group.

Conclusions: Radiotherapy is an important local therapy, which can significantly improve the tumor-specific survival and OS of frontal GBM patients. With the arrival of the era of precision radiotherapy, the continuous progress of radiotherapy technology may bring more benefits to frontal GBM patients.