Temporalis muscle width as a measure of sarcopenia correlates with overall survival in patients with newly diagnosed glioblastoma
Autor: | Cheng-Chia Wu, Tony J. C. Wang, Anurag Saraf, Gabrielle Estevez-Inoa, Mark E. Hwang, Akshay V. Save, Simon K. Cheng, Catherine S. Spina, Kristin Hsieh |
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Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Temozolomide business.industry Proportional hazards model medicine.medical_treatment Urology Temporalis muscle medicine.disease 030218 nuclear medicine & medical imaging Radiation therapy 03 medical and health sciences 0302 clinical medicine Surgical oncology 030220 oncology & carcinogenesis Sarcopenia medicine Overall survival business Glioblastoma medicine.drug |
Zdroj: | Journal of Radiation Oncology. 8:379-387 |
ISSN: | 1948-7908 1948-7894 |
Popis: | Sarcopenia has been shown to correlate with poor oncologic outcomes, but the optimal method to evaluate sarcopenia and its use as a prognostic tool in glioblastoma multiforme (GBM) remain unclear. We developed a method to reproducibly quantify sarcopenia using the temporalis muscle and correlated sarcopenia with overall survival (OS) in GBM patients. We measured the temporalis muscle width (TMW) on the postoperative radiotherapy CT simulation scan of 87 newly diagnosed GBM patients from 2011 to 2016. All patients successfully completed standard of care radiotherapy to a dose of 6000 cGy in 30 fractions with concurrent temozolomide without treatment breaks. TMW was measured bilaterally on four axial CT slices defined by bony orbit anatomy: orbit ceiling, superior quarter (equidistant between orbit and mid-orbit), mid-orbit, and inferior quarter (equidistant between mid-orbit and orbit floor). For analysis, TMW was dichotomized to either wide or narrow TMW by the median TMW and correlated with OS using Cox regression models. TMW at the orbit inferior quarter significantly correlated with OS. Median OS for wide TMW (> 1.583 cm) was greater than that of narrow TMW: 28.3 mo vs. 22.2 mo (HR (wide/narrow) = 0.42, 95% CI = (0.22, 0.82), p = 0.01), controlling for resection type and MGMT methylation. This effect was pronounced especially in the following patient subsets: females (HR (wide/narrow) = 0.26, 95% CI = (0.07, 0.92), p = 0.04) and patients without MGMT methylation (HR = 0.35, 95% CI = (0.15, 0.81), p = 0.01). Our results suggest sarcopenia and TMW correlate with GBM OS. Prospective validation of sarcopenia is needed to evaluate its potential in determining optimal patient treatment. |
Databáze: | OpenAIRE |
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