GLIOMA-15 RETROSPECTIVE REVIEW OF GLIOBLASTOMA MULTIFORME CASES MANAGED AT A TERTIARY LEVEL HOSPITAL IN KENYA

Abstract Glioblastoma Multiforme(GBM) is one of the most aggressive tumors of the central nervous system. Though rare, it accounts for the commonest primary brain tumor in adults. Despite recent advances in the treatment of patients with GBM, it portends a poor prognosis. There is limited published data of GBM from sub-Saharan Africa(SSA). We performed a retrospective chart review of 24 patients seen in the Medical Oncology service at the Aga Khan University Hospital between January 2018 and December 2020. Clinical, radiological, pathological outcomes were investigated, analyzed and compared with data from the literature. A total of twenty-four patients were seen at the medical oncology clinic over the 3-year period. The median age of the patients was 54 years (IQR 44.7-65) and majority of patients (>80%) were of African descent. Of the 24 patients, 13(54.2%) were male and 11(45.8%) were female. Headaches were the commonest clinical presentation and frontal lobe was commonest tumor location on imaging. The median size of the tumor was 4.5cm (IQR 3.8-6.45). Following diagnosis, eighteen(75%) patients underwent maximal safe resection of the tumor with presence of residual tumor in thirteen (56%) of the post-operative scans. Nineteen patients(83%) were initiated on concurrent chemotherapy (Temozolamide) and Radiation therapy (CCRT) as part of adjuvant treatment. Of those initiated on adjuvant Temozolamide following CCRT, more than one-third completed one year of treatment. At 6 months following diagnosis, 25% of patients remained stable while 25% had disease progression. Our study adds to the literature which demonstrates that patients seen in SSA with GBM present at younger age, with bigger tumor size but tend to do better compared to those in the west. Understanding of the molecular alterations within the tumor and larger prospective studies are needed to define the behavior of GBM in SSA.