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Literature Review of Spinal Cord Glioblastoma

Timmons, Joshua J., BS*; Zhang, Kisa, BS*; Fong, Johnson, BS*; Lok, Edwin, MS*; Swanson, Kenneth D., PhD*; Gautam, Shiva, PhD; Wong, Eric T., MD*

American Journal of Clinical Oncology: December 2018 - Volume 41 - Issue 12 - p 1281–1287
doi: 10.1097/COC.0000000000000434
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Objectives: This systematic review aims to investigate spinal cord glioblastoma (scGBM) and correlations between patient traits and survival outcome, as well as differences in cohorts administered temozolomide or total resections, through an analysis of published cases reported up to October 2016.

Methods: We obtained patient data by querying PubMed and Google Scholar with predetermined search terms and inclusion criteria that enabled the identification of relevant case reports. Survival was compared using Kaplan-Meier curves and log-rank analyses.

Results: Of 153 patients with scGBM identified through a literature search, 135 met the predetermined search and inclusion criteria. Median overall survival (OS) for the resulting cohort was 12 (95% CI, 10-14) months. The female sex was found to significantly predict worse outcomes, and a sizable number of patients with long-term disease were found to have afflictions of the thoracic spinal cord. Neither the pediatric, temozolomide nor total resection subgroups had significantly improved survival characteristics, by log-rank analysis, relative to counterparts.

Conclusions: These data elucidate the characteristics of patients with scGBM. For more sophisticated and in-depth analyses in the future, it is imperative that time-of-treatment information is recorded in future case reports. In addition, all case reports should be made available to prevent publication bias.

*Brain Tumor Center & Neuro-Oncology Unit, Department of Neurology

Biostatistics Section, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA

J.J.T. and K.Z. contributed equally.

Present address: Shiva Gautam, PhD, Department of Biostatistics, University of Florida College of Medicine Jacksonville, Jacksonville, FL.

Supported in part by A Reason to Ride research fund.

J.J.T.: study concept and design, acquisition of data, analysis and interpretation and critical revision of manuscript for intellectual content. K.Z., J.F., E.L.: acquisition of data, analysis, and interpretation. K.D.S.: analysis and interpretation, and critical revision of manuscript for intellectual content. S.G.: analysis and interpretation. E.T.W.: study concept and design, acquisition of data, analysis and interpretation, study supervision and critical revision of manuscript for intellectual content.

E.T.W.: received research support from AstraZeneca, Cephalon, Eli Lilly, Northwest Biotherapeutics, Novartis, Novocure, Pfizer, Plexxicon, and Tocagen. K.D.S.: received research support from Novocure and Tocagen. The remaining authors declare that they have nothing to disclose.

Reprints: Eric T. Wong, MD, Brain Tumor Center & Neuro-Oncology Unit, Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215. E-mail: ewong@bidmc.harvard.edu.

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