Postoperative clinical prognosis in 160 cases of glioblastoma and efficacy of vascular targeted therapy for recurrence

Jiayuan Li, Liubing Hou, Huandi Zhou, Zizhou Zhang, Yu Wang, Xiang Zhan, Wenyan Wang, Lei Tian,  Xiaoying Xue

Abstract:

Glioblastoma (GBM) is the most common primary malignant brain tumor. Concurrent chemoradiotherapy and adjuvant chemotherapy have become the standard treatment modalities after surgery. However, despite such aggressive treatment, the overall survival (OS) rate remains low, and the disease is highly prone to recurrence with an extremely poor prognosis after recurrence. Currently, there is no standard salvage treatment regimen. This study conducted a clinical prognostic analysis of 160 patients with GBM after surgery and evaluated the clinical efficacy of anti-angiogenic drugs (apatinib/bevacizumab) as salvage treatment after recurrence, providing a strong direction for future treatment. Among the 160 patients with GBM included in the study, univariate analysis showed that age, use of apatinib, adjuvant chemotherapy, and radiotherapy were significantly associated with OS, while gender, CD34 expression, Ki-67 expression, bevacizumab, and P53 expression were not significantly associated with OS. Multivariate analysis revealed that adjuvant chemotherapy, age, and radiotherapy were independent prognostic factors for OS in patients with GBM. The median overall survival of the entire cohort was 20.0 months, with 1-year, 3-year, and 5-year survival rates of 74.6%, 28.7%, and 12.4%, respectively. Analysis of the clinical efficacy of salvage chemotherapy in 65 patients with recurrent GBM showed that the combined anti-angiogenic drug group had a significant survival advantage compared to the chemotherapy-only group (33 months vs. 19 months). Among patients in the combined anti-angiogenic drug group, 36 patients achieved clinical control, with a disease control rate (DCR) of 73.47%, significantly higher than the 43.75% DCR in the control group. The chemotherapy combined with apatinib group had a significant survival advantage in OS (p = 0.012) and also benefited in DCR (66.67% vs. 43.75%); however, the chemotherapy combined with the bevacizumab group did not show a survival benefit in OS (p = 0.078).