ArticleCurrent oncology (Toronto, Ont.)2026
Retrospective Monocentric Analysis of Carmustine Wafer Implantation in Recurrent Glioblastoma: Impact on Survival and Key Prognostic Factors.
Article in Current oncology (Toronto, Ont.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe implantation of biodegradable carmustine (BCNU) wafers is a treatment option for recurrent high-grade glioma (HGG), but its efficacy is debated. We evaluated its impact on overall survival (OS) and survival after recurrence (SAR) considering recurrence timing after first-line treatment.
methodsIn this single-center retrospective study, we analyzed patients who underwent surgery for glioblastoma (GBM) recurrence following initial diagnosis (pre- and post-WHO classification 2016) between 2007 and 2022. All patients received standard first-line therapy, including maximal safe resection, radiotherapy with concomitant temozolomide, and adjuvant temozolomide. Recurrent GBM treatment involves resection, with or without adjuvant chemo- and/or radiotherapy. Patients who received carmustine wafer implantation (CWI) during resection were compared to those without wafer placement. Recurrences were classified by timing relative to first-line therapy: (1) post-radiochemotherapy, pre-adjuvant temozolomide; (2) during adjuvant temozolomide; (3) during prolonged temozolomide; (4) >1 month after completion of all therapy. Primary endpoints were OS and SAR, with prognostic factors analyzed.
resultsA total of 176 patients were enrolled, with 59.7% (105/176) receiving CWI. Recurrence treatment included surgery without adjuvant therapy in 23.3% (41/176) of cases (26.7% of CWI+ and 18.3% of CWI-), adjuvant chemotherapy in 39.8% (70/176) (41% of CWI+ and 38% of CWI-), radiotherapy in 7.4% (13/176) (7.6% of CWI+ and 7% of CWI-), and combined radiochemotherapy in 29.5% (52/176) (24.8% of CWI+ and 36.6% of CWI-). No significant differences were found between groups in age (
conclusionsCWI did not significantly improve OS or SAR in recurrent GBM patients. However, younger age, MGMT methylation, smaller residual tumor volume, and later recurrence were linked to better survival outcomes, underscoring their prognostic importance.
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