EPIDEMIOLOGY, IMAGING, DIAGNOSIS, CLINICAL PRESENTATIONS AND TREATMENT OF PRIMARY GLIOBLASTOMA IN RELATION TO PROGNOSIS: A CLINICAL CASE STUDY

Abstract

GBM is the most common primary intracranial malignancy. Previous studies found its incidence varying substantially by age, sex, race and ethnicity and survival also varies by country, ethnicity and treatment. There is slight predominance in males, incidence increases with age. The standard approach of therapy is the newly diagnosed setting include surgery followed by concurrent radiotherapy with temozolomide. The recently revised classication of GBM is based on molecular proling notably isocitrate dehydrogenase mutation status. Our study included only patients who had undergone surgery in our institute in the past 1 year and diagnosed with grade IV astrocytoma as per biopsy report. We have excluded patients with other high grade tumors. We have used non-invasive brain imaging techniques such as CT scan and MRI for visualising tumors. We have included 32 patients, 22 men and 10 women, who were diagnosed with glioblastoma in our institute in the past 1 year . The median age of diagnosis among men is 50 years and that of women is 46 years. All of our patients were from Eastern India. Among these, 8 men and 2 women expired within 3 months of undergoing surgery before radiotherapy and chemotherapy. Thus, the mortality rate was nearly 31% during our study. We have found most of the patients presenting with headache, nausea, vomiting, seizure and hemiparesis. Extent of resection has varied from patient to patient thus leading to differences in outcome, morbidity and mortality. Outcome depends on performance status, advanced age, eloquent location, extent of resection and availability of chemo-radiotherapy.