Preoperative Tumor Growth Rate Does Not Predict Overall or Progression-free Survival in Patients With Glioblastoma.

IF 1.6 4区医学 Q4 ONCOLOGY

Anticancer research Pub Date : 2024-11-01 DOI:10.21873/anticanres.17328

Jan Leppert, Claudia Ditz, Jakob Matschke, Maria Vittoria Matone, Patrick Kuppler, Christina Hillbricht, Harald Krenzlin, Naureen Keric, Hannes Schacht, Christian Ziemann, Elisa Maria Groh, Larysa Liubich, Oksana Zemskova, Dirk Rades, Anastassia Löser

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引用次数: 0

Abstract

Background/aim: Presurgical tumor volume progression in glioblastoma (GBM) may be a predictor of survival. This study aims to evaluate the potential impact of preoperative tumor growth and other clinical as well as laboratory parameters on overall survival (OS) of GBM patients.

Patients and methods: We retrospectively analyzed 98 adult patients with GBM who received two magnetic resonance imaging (MRI) scans between 2013 and 2023, before primary surgery and concurrent Stupp chemoradiotherapy. Tumor growth rates were calculated to classify GBM into slower and faster growing categories. Statistical analyses, including Kaplan-Meier and multivariable Cox regression survival analyses, were performed to evaluate the impact of various clinical and treatment-related factors on OS and progression-free survival (PFS).

Results: Slower growing tumors had a significantly longer doubling time than faster growing lesions. Univariable analysis showed no significant differences in OS (p=0.12) or PFS (p=0.4) when analyzed according to tumor growth. When stratified by O6-methylguanin-DNA-methyltransferase (MGMT) status, there were still no differences in OS (p=0.14), but in PFS (p=0.009). In the multivariable Cox regression analysis, radiation dose (p=0.02) and the number of adjuvant cycles of temozolomide (TMZ) (p=0.002) were significantly associated with OS. MGMT status (p=0.02) and the number of adjuvant TMZ cycles (p<0.001) were significantly associated with prolonged PFS. Specific volume growth rate (SVGR), patient age, baseline tumor volume, Karnofsky performance status, extent of resection, and total radiation dose were not significantly associated with PFS.

Conclusion: SVGR was not significantly associated with OS or PFS. In contrast, MGMT status, radiation dose, and number of adjuvant TMZ cycles were identified as predictors of treatment outcomes. These factors can guide physicians when designing personalized treatment concepts for patients with GBM.

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术前肿瘤生长率不能预测胶质母细胞瘤患者的总生存期或无进展生存期

背景/目的：胶质母细胞瘤（GBM）术前肿瘤体积进展可能是生存率的预测因素。本研究旨在评估术前肿瘤生长和其他临床及实验室参数对GBM患者总生存期（OS）的潜在影响：我们回顾性分析了在2013年至2023年期间接受过两次磁共振成像（MRI）扫描的98例GBM成人患者，这些患者在初次手术和同期的Stupp化放疗之前接受了磁共振成像扫描。通过计算肿瘤生长率，将GBM分为生长速度较慢和较快两类。统计分析包括Kaplan-Meier和多变量Cox回归生存分析，以评估各种临床和治疗相关因素对OS和无进展生存期（PFS）的影响：结果：生长速度较慢的肿瘤的倍增时间明显长于生长速度较快的病变。单变量分析显示，根据肿瘤生长情况进行分析，OS（P=0.12）和PFS（P=0.4）无显著差异。根据O6-甲基鸟嘌呤-DNA-甲基转移酶（MGMT）状态进行分层后，OS（P=0.14）和PFS（P=0.009）仍无差异。在多变量考克斯回归分析中，放射剂量（p=0.02）和替莫唑胺（TMZ）辅助周期数（p=0.002）与OS显著相关。MGMT状态（p=0.02）和替莫唑胺（TMZ）辅助周期数（p=0.002）与OS显著相关：SVGR与OS或PFS无明显相关性。相比之下，MGMT状态、放射剂量和TMZ辅助周期数被认为是治疗结果的预测因素。这些因素可以指导医生为 GBM 患者设计个性化治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.