Opening the ventricle during surgery diminishes survival among patients with newly diagnosed glioblastoma treated with carmustine wafers: a multi-center retrospective study

Yukihiko Sonoda, Ichiyo Shibahara, Ken ichiro Matsuda, Ryuta Saito, Tomoyuki Kawataki, Masaya Oda, Yuichi Sato, Hirokazu Sadahiro, Sadahiro Nomura, Toshio Sasajima, Takaaki Beppu, Masayuki Kanamori, Kaori Sakurada, Toshihiro Kumabe, Teiji Tominaga, Hiroyuki Kinouchi, Hiroaki Shimizu, Kuniaki Ogasawara, Michiyasu Suzuki

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Carmustine wafers (CW) were approved in Japan for newly diagnosed and recurrent malignant gliomas during 2013. The ventricle is often opened during surgery to achieve maximum resection. While not generally recommended in such situations, CW might be safely achieved by occluding an opened ventricle using gelform or collagen sheets. However, whether CW implantation actually confers a survival benefit for patients who undergo surgery with an open ventricle to treat glioblastoma remains unclear. Clinical, imaging, and survival data were collected in this multicenter retrospective study of 122 consecutive patients with newly diagnosed glioblastoma to determine adverse events and efficacy. Overall, 54 adverse events of all grades developed in 35 (28.6%) patients, with the most common being new seizures (16%). Adverse events did not significantly differ between patients with opened and closed ventricles during surgery. The 10- and 21.7-month, median, progression-free (PFS) and overall survival (OS), respectively did not significantly differ according to resection rates. However, median PFS and OS were significantly longer among patients with closed, than open ventricles (12.8 vs. 7.4 months; p = 0.0039 and 26.9 vs. 18.6 months; p = 0.011, respectively). Implanting CW into the resection cavity during concomitant radiochemotherapy with temozolomide seems to yield better survival rates without increased adverse events. Occlusion of the ventricular opening during surgery might be safe for CW implantation, but less so for treating patients with newly diagnosed glioblastoma.

Original languageEnglish
Pages (from-to)83-88
Number of pages6
JournalJournal of Neuro-Oncology
Volume134
Issue number1
DOIs
Publication statusPublished - 2017 Aug 1

Keywords

  • Carmustine wafers
  • Glioblastoma
  • Ventricle

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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