Aim: To assess for variations in patterns of care in first line treatment and survival for patients with glioblastoma (GBM) in Queensland.
Methods: This retrospective population-based study used data from the Queensland Oncology Repository, a comprehensive repository which contains demographic, diagnosis, and treatment data on Queenslanders diagnosed with cancer. The study population included patients aged 18+ years diagnosed with glioblastoma (GBM) from 2009 to 2019. We examined patterns of treatment according to age group and location. Cox Proportional Hazards model was used to examine the risk of death.
Results: Of 2,334 patients diagnosed with glioblastoma, 60.4% were male, 1.2% were First Nations peoples and median age at diagnosis was 64 years (range 18-85). These patients were treated across 58 public and private centres with approximately 70% receiving their primary treatment in 5 of these centres. Frontal and temporal lesions were the most common (31.0% and 26.4%, respectively). The most common treatment approaches were combination surgery, radiation therapy (RT) and chemotherapy (CT) (39.4%), surgery and RT (20.1%) and surgery only (18.1%) of which more than half were a biopsy alone. One in ten patients had no treatment with this being more common in those aged 70+ years (p <0.001). Median GBM-specific survival for patients who received treatment was 10.1 months and 2.1 months for those who did not receive treatment (p <0.001). Risk of GBM-specific death occurring before 10.1 months was associated with increasing age (p <0.001), higher comorbidity burden (p <0.001) and not receiving RT or CT (p <0.001 and p <0.001, respectively). There was no significant correlation between death from GBM and socioeconomic status, location nor being of First Nations origin.
Conclusion: While survival following a diagnosis of GBM remains poor, multimodality treatment confers a significant survival advantage. Treatment outcomes did not differ significantly across metropolitan and regional areas.