ArticleCancers2026
Trends in Treatment and Survival Among Patients with Glioblastoma in the United States from 2000 to 2020.
Article in Cancers, 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
backgroundPopulation-level patterns in the real-world use of initial treatment combinations for glioblastoma (GBM) remain poorly characterized. MATERIALS AND
methodsWe assessed temporal trends in treatment and survival among patients with GBM in the SEER registry. Guideline-concordant multimodal therapy was defined as cancer-directed surgery combined with radiotherapy and chemotherapy. Outcomes were further stratified by extent of resection, including gross total resection (GTR) versus subtotal resection.
resultsAmong 46,186 patients, 43.5% underwent GTR, 32.0% subtotal resection, and 24.5% no surgery; 71.8% received radiotherapy and 61.3% received chemotherapy. From 2000 to 2020, utilization increased for any surgery (OR/year 1.03, 95% CI 1.028-1.036), radiotherapy (1.01, 1.010-1.017), and chemotherapy (1.08, 1.081-1.088), whereas the likelihood of GTR vs. subtotal resection declined (0.92, 0.915-0.922). Triple therapy increased modestly (1.01, 1.005-1.012) but plateaued at 30%. Older age, non-lobar tumors, unmarried status, and lower income predicted lower odds of triple therapy; after adjustment, calendar year showed a marginal decline in the odds of receiving triple therapy (aOR/year 0.99, 0.99-1.00). Median overall survival improved from 6.0 to 10.0 months, with gains in fixed-time survival. Patients receiving multimodal therapy demonstrated the longest survival overall; within this group, GTR-based multimodal therapy was associated with longer survival than subtotal resection-based multimodal therapy across age strata.
conclusionsGuideline-concordant multimodal therapy was associated with the longest survival. GTR rates did not rise in recent years, and substantial disparities in the deployment of GTR-based multimodal therapy persisted. Efforts to expand equitable access and prioritize maximal safe resection are essential to achieve greater population-level survival gains. These differences should be interpreted cautiously, as SEER cannot distinguish appropriate clinical treatment selection from limited access to care or treatment ineligibility.
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