Ayoub Zeina, Geara Fady, Najjar Marwan, Comair Youssef, Khoueiry-Zgheib Nathalie, Khoueiry Pierre, Mahfouz Rami, Boulos Fouad I, Kamar Francois G, Andraos Therese, Saadeh Fadi, Kreidieh Firas, Abboud Miguel, Skaf Ghassan, Assi Hazem I
Department of Radiation Oncology, The Naef K. Basile Cancer Institute, The American University of Beirut Medical Center, Beirut, Lebanon.
Department of Surgery, The American University of Beirut Medical Center, Beirut, Lebanon.
Clin Neurol Neurosurg. 2019 Jul;182:92-97. doi: 10.1016/j.clineuro.2019.04.008. Epub 2019 Apr 29.
To determine the prevalence and prognostic value of MGMT promoter methylation and IDH1 mutation in glioblastoma multiforme (GBM) patients from the Middle East.
Records of patients diagnosed between 2003 and 2015 were reviewed. MGMT promoter methylation was measured using methylation-specific polymerase chain reaction and IDH-1 mutation was reported. The primary endpoint was overall survival (OS).
A total of 110 patients were included. The median age was 51 years and 71 patients (64.5%) were males. The median diameter of GBM was 4.6 cm and 29 patients (26.4%) had multifocal disease. Gross total resection was achieved in 38 patients (24.9%). All patients received adjuvant radiation therapy, and 96 patients (91.4%) received concomitant temozolomide. At a median follow up of 13.6 months, the median OS was 17.2 months, and the OS at 1 and 2 years were 71.6% and 34.8%, respectively. On multivariate analysis, age at diagnosis (HR 1.019; P = 0.044) and multifocality (HR 2.373; P = 0.001) were the only independent prognostic variables. MGMT promoter methylation was found in 28.2% of patients but did not significantly correlate with survival (HR 1.160; P = 0.635). IDH-1 mutation was found in 10% of patients was associated with a non-significant trend for survival improvement (HR 0.502; P = 0.151).
Patients with GBM from the Middle East have adequate survival outcomes when given the optimal treatment. In our patient population, MGMT promoter methylation did not seem to correlate with outcomes, but patients with IDH1 mutation had numerically higher survival outcomes.
确定中东地区多形性胶质母细胞瘤（GBM）患者中O6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）启动子甲基化和异柠檬酸脱氢酶1（IDH1）突变的患病率及预后价值。
回顾2003年至2015年间确诊患者的记录。采用甲基化特异性聚合酶链反应检测MGMT启动子甲基化，并报告IDH-1突变情况。主要终点为总生存期（OS）。
共纳入110例患者。中位年龄为51岁，71例（64.5%）为男性。GBM的中位直径为4.6 cm，29例（26.4%）有多发病灶。38例（24.9%）患者实现了大体全切除。所有患者均接受了辅助放疗，96例（91.4%）接受了同步替莫唑胺治疗。中位随访13.6个月时，中位OS为17.2个月，1年和2年时的OS分别为71.6%和34.8%。多因素分析显示，诊断时年龄（风险比[HR] 1.019；P = 0.044）和多灶性（HR 2.373；P = 0.001）是仅有的独立预后变量。28.2%的患者发现MGMT启动子甲基化，但与生存无显著相关性（HR 1.160；P = 0.635）。10%的患者发现IDH-1突变，与生存改善的非显著趋势相关（HR 0.502；P = 0.151）。
给予最佳治疗时，中东地区的GBM患者有适当的生存结局。在我们的患者群体中，MGMT启动子甲基化似乎与结局无关，但IDH1突变患者的生存结局在数值上更高。
