Jaspar Witteler1, Steven E Schild2, Dirk Rades3. 1. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany. 2. Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A. 3. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany; dirk.rades@uksh.de.
Abstract
BACKGROUND/AIM: Standard treatment of glioblastoma multiforme (GBM) includes resection, longer-course radiotherapy and chemotherapy. Some patients cannot tolerate these regimens and may benefit from personalized treatments. This study aims to contribute to treatment personalization by identifying predictors of outcomes after longer-course radiotherapy. PATIENTS AND METHODS: In 91 patients, number/site/diameter of lesions, Ki-67, MGMT promoter methylation, Karnofsky performance score (KPS), symptoms, gender, age and resection were evaluated for local control and survival. RESULTS: On univariate analyses, gross resection (p=0.029) was significantly associated with improved local control. It maintained significance in the multivariate analysis [hazard ratio (HR)=1.64, p=0.025]. MGMT-methylation (p=0.004), KPS ≥80 (p=0.022) and resection (p<0.001) were significantly associated with improved survival on univariate analyses, unifocal GBM (p=0.056) showed a trend. In the multivariate analyses, MGMT-methylation (HR=3.63, p=0.009), KPS (HR=2.01, p=0.018) and resection (HR=3.29, p<0.001) were significant. CONCLUSION: Predictors of local control and survival were identified that may guide physicians when tailoring treatments to patients with GBM.
BACKGROUND/AIM: Standard treatment of glioblastoma multiforme (GBM) includes resection, longer-course radiotherapy and chemotherapy. Some patients cannot tolerate these regimens and may benefit from personalized treatments. This study aims to contribute to treatment personalization by identifying predictors of outcomes after longer-course radiotherapy. PATIENTS AND METHODS: In 91 patients, number/site/diameter of lesions, Ki-67, MGMT promoter methylation, Karnofsky performance score (KPS), symptoms, gender, age and resection were evaluated for local control and survival. RESULTS: On univariate analyses, gross resection (p=0.029) was significantly associated with improved local control. It maintained significance in the multivariate analysis [hazard ratio (HR)=1.64, p=0.025]. MGMT-methylation (p=0.004), KPS ≥80 (p=0.022) and resection (p<0.001) were significantly associated with improved survival on univariate analyses, unifocal GBM (p=0.056) showed a trend. In the multivariate analyses, MGMT-methylation (HR=3.63, p=0.009), KPS (HR=2.01, p=0.018) and resection (HR=3.29, p<0.001) were significant. CONCLUSION: Predictors of local control and survival were identified that may guide physicians when tailoring treatments to patients with GBM.
Authors: Svenja Kopelke; Troels W Kjaer; Soeren Tvilsted; Steven E Schild; Tobias Bartscht; Dirk Rades Journal: In Vivo Date: 2022 Jan-Feb Impact factor: 2.155