Objective:

To investigate factors influencing the implementation of the Stupp protocol for glioblastoma and assess the impact of treatment timing, SGS-Boost, dexamethasone levels, and adjuvant temozolomide cycles on patient outcomes.

Approach:

• Study Design: A retrospective analysis of 269 glioblastoma patients treated at a single institution from 2016 to 2024, focusing on treatment adherence and outcomes.
• Patient Selection: Patients were selected based on 2021 WHO criteria, excluding those with insufficient records or specific genetic mutations.
• Treatment Analysis: Assessment of treatment modalities including the Stupp protocol, SGS-Boost, and dexamethasone administration at various intervals.
• Statistical Methods: Utilized Kaplan-Meier survival analysis, Cox multivariable analysis, and various statistical tests to evaluate outcomes.

Key Findings:

• Age was the only significant demographic factor associated with reduced receipt of the Stupp protocol, particularly in patients aged ≥ 70.
• 93% of patients < 70 years underwent maximal resection compared to only 78% of those ≥ 70 years.
• Only 44% of fully resected patients aged ≥ 70 years received the standard chemoradiotherapy regimen.

Interpretation:

Limitations:

• The study is retrospective and may be subject to selection bias.
• Limited generalizability due to single-institution data.
• Potential confounding factors not accounted for in the analysis.

Conclusion:

Sources:

• Stupp Protocol Reference
• WHO Diagnostic Criteria