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Introduction <p>Glioblastoma (GBM) is the most common primary malignant tumor of the central nervous system, primarily affecting the brain. It infrequently occurs in the spinal cord, accounting for approximately 1.5% of all spinal cord tumors. Primary spinal cord GBM (sGBM) is associated with a poor prognosis, with a median overall survival (OS) of 12–15 months and a median progression-free survival (PFS) of 11.5 months. This study performed a systematic review and a individual participant data meta-analysis to evaluate the impact of various therapeutic strategies on OS and PFS in patients with sGBM.</p> Methods <p>Following PRISMA guidelines, data from 278 patients extracted from 116 studies were analyzed. The literature search was conducted in August 2025 using the PubMed and Embase databases. Statistical analyses included Kaplan–Meier survival curves, the log-rank test, and univariate and multivariate Cox regression models.</p> Results <p>The average age was 31 years, with a predominance of males (57.5%). Most patients underwent STR (63.6%) and received adjuvant treatment (84.6%). Mean OS was 16.1 months, while mean PFS was 11.6 months. Chemotherapy (CT) and Radiotherapy (RT) were associated with improved prognosis. Moreover, patients who underwent gross total resection (GTR) showed a lower risk of mortality compared with those who underwent Bx.</p> Conclusion <p>Chemotherapy, radiotherapy, and gross total resection demonstrated significant benefits for both OS and PFS. These findings underscore the relevance of adjuvant therapies and surgical extent in the management of primary spinal GBM. Future studies should address the impact of tumor genetic and molecular profiles on survival outcomes.</p>

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Influence of treatment modalities on survival and progression free survival in primary spinal cord glioblastoma: a systematic review and individual participant data meta-analysis

  • 期刊论文

  • 发表日期：

    2025年11月20日

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  • Pedro Lucas Negromonte Guerra,
  • Inaê Carolline Silveira Silva,
  • Deoclides Lima,
  • Mateus Rodrigues Souza,
  • Tomoo Inoue,
  • Toshiki Endo,
  • Eduardo Vieira Carvalho Júnior

摘要

Introduction

Glioblastoma (GBM) is the most common primary malignant tumor of the central nervous system, primarily affecting the brain. It infrequently occurs in the spinal cord, accounting for approximately 1.5% of all spinal cord tumors. Primary spinal cord GBM (sGBM) is associated with a poor prognosis, with a median overall survival (OS) of 12–15 months and a median progression-free survival (PFS) of 11.5 months. This study performed a systematic review and a individual participant data meta-analysis to evaluate the impact of various therapeutic strategies on OS and PFS in patients with sGBM.

Methods

Following PRISMA guidelines, data from 278 patients extracted from 116 studies were analyzed. The literature search was conducted in August 2025 using the PubMed and Embase databases. Statistical analyses included Kaplan–Meier survival curves, the log-rank test, and univariate and multivariate Cox regression models.

Results

The average age was 31 years, with a predominance of males (57.5%). Most patients underwent STR (63.6%) and received adjuvant treatment (84.6%). Mean OS was 16.1 months, while mean PFS was 11.6 months. Chemotherapy (CT) and Radiotherapy (RT) were associated with improved prognosis. Moreover, patients who underwent gross total resection (GTR) showed a lower risk of mortality compared with those who underwent Bx.

Conclusion

Chemotherapy, radiotherapy, and gross total resection demonstrated significant benefits for both OS and PFS. These findings underscore the relevance of adjuvant therapies and surgical extent in the management of primary spinal GBM. Future studies should address the impact of tumor genetic and molecular profiles on survival outcomes.