Quantitative assessment of residual tumor is a strong and independent predictor of survival in methylated glioblastoma following radiochemotherapy with CCNU/TMZ.

Autor:	Zeyen T; Department of Neurooncology, Center for Neurology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Böhm L; Department of Neurooncology, Center for Neurology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Paech D; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Schäfer N; Department of Neurooncology, Center for Neurology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Tzaridis T; Department of Neurooncology, Center for Neurology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Duffy C; Department of Neurooncology, Center for Neurology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Nitsch L; Department of Vascular Neurology, Center for Neurology, University Hospital Bonn, Bonn, Germany., Schneider M; Department of Neurosurgery, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Potthoff AL; Department of Neurosurgery, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Schneider-Rothhaar JL; Department of Neurosurgery, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Steinbach JP; Dr. Senckenberg Institute of Neurooncology, University of Frankfurt, Frankfurt,Germany., Hau P; Department of Neurology and Wilhelm Sander NeuroOncology Unit, University Hospital Regensburg, Regensburg, Germany., Kowalski T; Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum., Seidel C; Department of Radiation Oncology University of Leipzig, Leipzig, Germany., Krex D; Technische Universität Dresden, Faculty of Medicine and University Hospital Carl Gustav Carus, Department of Neurosurgery, Fetscherstrasse 74, 01307 Dresden, Germany., Grauer O; Department of Neurology University of Münster, Münster, Germany., Goldbrunner R; Center of Neurosurgery Department of General Neurosurgery University of Cologne, Cologne, Germany.; Center for Integrated Oncology (CIO ABCD)., Zeiner PS; Dr. Senckenberg Institute of Neurooncology, University of Frankfurt, Frankfurt,Germany., Tabatabai G; Department of Neurology & Interdisciplinary Neuro-Oncology, University Hospital Tübingen, Hertie, Institute for Clinical Brain Research, Eberhard Karls University Tübingen.; Center for Neuro-Oncology, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Eberhard Karls University Tübingen., Galldiks N; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany and Research Center Juelich, Inst. of Neuroscience and Medicine (INM-3), Juelich, Germany.; Center for Integrated Oncology (CIO ABCD)., Stummer W; Department of Neurosurgery, University of Münster, Münster, Germany., Hattingen E; Department of Neuroradiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany., Glas M; Division of Clinical Neurooncology, Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, University Duisburg-Essen, Essen, Germany.; German Cancer Consortium (DKTK), Partner Site University Medicine Essen, Hufelandstr. 55, 45147 Essen, Germany., Gkika E; Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Vatter H; Department of Neurosurgery, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Radbruch A; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Herrlinger U; Department of Neurooncology, Center for Neurology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Weller J; Department of Neurooncology, Center for Neurology, University Hospital Bonn, Bonn, Germany.; Department of Vascular Neurology, Center for Neurology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD)., Schaub C; Department of Neurooncology, Center for Neurology, University Hospital Bonn, Bonn, Germany.; Center for Integrated Oncology (CIO ABCD).
Jazyk:	angličtina
Zdroj:	Neuro-oncology [Neuro Oncol] 2024 Oct 01. Date of Electronic Publication: 2024 Oct 01.
DOI:	10.1093/neuonc/noae205
Abstrakt:	Background: Maximum tumor resection improves overall survival (OS) in patients with glioblastoma. The extent of resection (EOR) is historically dichotomized. The RANO resect group recently proposed criteria for volumetry-based EOR assessment in patients that were treated according to Stupp´s protocol. The purpose of this study was (1) to investigate the prognostic value of EOR in patients receiving combined chemotherapy with lomustine (CCNU)/temozolomide (TMZ), and (2) to analyse the prognostic performance of binary EOR assessment compared to volumetric assessment. Methods: 78 patients with newly diagnosed MGMT-methylated GBM undergoing tumor resection followed by radiochemotherapy with CCNU/TMZ were included in this study. Residual contrast-enhancing (CE) tumor volume after the first resection was measured and its influence on OS and PFS was analysed using uni- and multivariable Cox regression analysis as well as two-sided log rank test. Patients were divided into RTV ≤1 cm³, >1 cm³ - ≤5 cm³ and >5 cm³ following the proposed criteria of the RANO resect group. Results: Prolonged OS was associated with age <60 years, low RTV, and gross total resection (GTR). Residual tumor volume (RTV) had a superior prognostic value compared to binary EOR assessment. Patients with total or near total resection of CE tumor (≤1 cm³ RTV) showed prolonged OS (median 54.4 months, 95% CI 46.94-not reached), with a 5-year survival rate of 49%. Conclusion: Low RTV is associated with increased survival in glioblastoma patients undergoing radiochemotherapy with CCNU/TMZ. This study demonstrates the applicability of the recently proposed RANO resect criteria in this subgroup of patients. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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