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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2023.tde-02082023-150631
Document
Author
Full name
Érida Aparecida Pinto Magaton
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2023
Supervisor
Committee
Diz, Maria Del Pilar Estevez (President)
Campolina, Alessandro Gonçalves
Carvalheira, José Barreto Campello
Santos, Daniela Vivas dos
Title in Portuguese
Estudo de mundo real, observacional, retrospectivo, nacional, para avaliação da efetividade, segurança e padrões radiológicos de resposta do tratamento de bevacizumabe em pacientes com glioblastoma recorrente
Keywords in Portuguese
Bevacizumab
Glioblastoma
Sobrevida
Terapêutica
Abstract in Portuguese
INTRODUÇÃO: O bevacizumabe (BVZ) é empregado no tratamento do glioblastoma recorrente desde 2009. Estudos demonstraram que BVZ prolonga a sobrevida livre de progressão nesse cenário, mas não a sobrevida global. Entretanto, a literatura sugere que em determinada subpopulação com progressão do GBM pode haver um benefício significativo em relação ao parâmetro de sobrevida global ao utilizar terapia anti-VEGF. Frente a esses resultados controversos, o objetivo primário deste estudo foi avaliar a sobrevida global de pacientes com GBM tratados com BVZ após progressão, em uma instituição brasileira. MÉTODO: Prontuários foram avaliados entre 2008 a 2020. Sobrevida global e livre de progressão foram avaliadas pelas curvas de Kaplan-Meier e comparadas pelo teste log-rank. RESULTADOS: Foram incluídos 39 pacientes. Um único procedimento cirúrgico foi realizado em 14 participantes (35,9%). Vinte e três (59,0%) pacientes foram submetidos a uma segunda cirurgia com a mesma finalidade. Dois pacientes (5,1%) foram operados três ou mais vezes. A mediana da sobrevida global (SG1) foi de 7,7 meses e de 21,2 meses para SG2. A mediana da sobrevida livre de progressão (SLP1) foi de 3,8 meses e 10,4 meses para SLP2. Não foram encontradas diferenças nas curvas de sobrevida em relação aos parâmetros radiológicos de resposta. CONCLUSÃO: apesar de notável que a SG2 dos pacientes tratados no ICESP está acima do que é encontrado em literatura, não encontramos parâmetros radiológicos preditivos de resposta
Title in English
Real-world, observational, retrospective, national study to evaluate the effectiveness, safety and radiological patterns of response to bevacizumab treatment in patients with recurrence of glioblastoma
Keywords in English
Bevacizumab
Glioblastoma
Survival
Therapeutics
Abstract in English
INTRODUCTION: Bevacizumab (BVZ) has been used in the treatment of recurrent glioblastoma (GBM) since 2009. Studies have shown that BVZ prolongs progression-free survival in this scenario, but not overall survival. However, the literature suggests that in a certain subpopulation with GBM progression there may be a significant benefit in relation to the overall survival parameter when using anti-VEGF therapy. Considering these controversial results, the primary objective of this study was to evaluate the overall survival of patients with GBM treated with BVZ after progression, in a Brazilian institution. METHOD: Medical records were evaluated between 2008 and 2020. Overall and progression-free survival were evaluated using Kaplan-Meier curves and compared using the log-rank test. RESULTS: 39 patients were included. A single surgical procedure was performed in 14 participants (35.9%). Twenty-three (59.0%) patients did a second surgery with the same purpose. Two patients (5.1%) did surgery three or more times. Median overall survival (OS1) was 7.7 months and 21.2 months for OS2. The median progression-free survival (PFS1) was 3.8 months and 10.4 months for PFS2. No differences were found in the survival curves in relation to the radiological response parameters. CONCLUSION: although it is notable that the OS2 of patients treated at ICESP is above what is found in the literature, we did not find radiological parameters predictive of response
 
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Publishing Date
2023-08-15
 
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