Aim: To assess variations in patterns of care in first-line treatment and survival for people with glioblastoma (GBM) in Queensland.
Methods: This retrospective population-based study used data from the Queensland Oncology Repository (QOR), a comprehensive repository which contains administrative, demographic, diagnosis, and treatment-related data on Queenslanders diagnosed with cancer. The study population included people diagnosed with GBM from 2011 to 2020. Variables examined include age, residential location, treatment location, surgery, and radiotherapy details. Chemotherapy data was incomplete and inaccurate and therefore excluded from analysis. Multivariate regression models were used to model factors associated with the likelihood of receiving treatment and odds of death.
Results: There were 2,113 people diagnosed with GBM during the study period; 60.2% male, median age at diagnosis 65 years (range 5-96) and 1.1% were First Nations peoples. Surgery and radiotherapy were delivered in 38 public and private centres, with 67% of care delivered in just 5 of these centres. Only 53% underwent both craniotomy and radiotherapy; 26% either craniotomy or radiotherapy alone; 21% received neither therapy. Median survival after craniotomy and radiation was 14.6 months. Median survival was 11.4 months for those patients receiving craniotomy or radiotherapy alone, compared to 1.8 months for those undergoing neither (p <0.001). Increased odds of death were associated with increasing age, higher comorbidity burden, not receiving radiotherapy (each p <0.001) and identifying as First Nations origin (p=0.02) but not remoteness of residence.
Conclusion: Following a diagnosis of GBM. only 53% of Queenslanders appear to receive the optimal treatment paradigm of craniotomy followed by radiotherapy, which warrants further investigation. Survival is comparable to other published data. Data surrounding chemotherapy for GBM is lacking from QOR and addressing this is important.