Aims:
Primary brain cancers are uncommon tumours with high morbidity and mortality. The most common brain cancer in adults is glioblastoma (GBM). The standard of care for good performance status patients after surgical debulking is post-operative radiotherapy and oral temozolamide. Older and poorer performance status patients generally receive lower doses of radiotherapy. The aim of this study was to review population-based outcomes for GBM in the Barwon South West Region (BSWR) of Victoria.
Methods:
The Evaluation of Cancer Outcomes (ECO) Registry records clinical and treatment information on all newly diagnosed cancer patients in the BSWR encompassing approximately 380,000 people. This study analysed patterns of care and outcomes for all GBM patients diagnosed in the BSWR from 2009-2019. Death data was available through to end of 2020.
Results:
There were 321 primary brain cancers diagnosed during the study period. GBM was the most common diagnosis (208 cases), followed by astrocytomas, other gliomas and oligodendrogliomas (42, 32 and 12 cases respectively). The median age of all GBM patients was 76 and median survival 11 months. Sixty patients had no record of radiotherapy in the BSWR - this group had a median age of 81 and median survival of 3.1 months. Patients known to receive radiotherapy were split into high, medium and low dose groups with median ages and survivals of 68 years and 15.4 months, 78 years and 7.5 months, 83 years and 5.9 months respectively. Palliative care referrals were in place for approximately 50% of patients, while advanced care plans (ACP) were more frequent from 2015 onwards (19% of cases).
Conclusions:
Although the BSWR lacked neurosurgical services during the study period, GBM patients appeared to have care patterns and outcomes in line with major published studies. Given the poor outcomes, referrals to palliative care services and lodgement of ACP appeared lower than might be expected.