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多形性胶质母细胞瘤(GBM)患者放疗的局部控制和生存的预后因素。

Prognostic Factors of Local Control and Survival in Patients Irradiated for Glioblastoma Multiforme (GBM).

机构信息

Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.

Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.

出版信息

Anticancer Res. 2020 Dec;40(12):7025-7030. doi: 10.21873/anticanres.14728. Epub 2020 Dec 7.

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.

摘要

背景/目的:多形性胶质母细胞瘤(GBM)的标准治疗包括切除、长时间放射治疗和化疗。有些患者无法耐受这些方案,可能会从个体化治疗中获益。本研究旨在通过确定长时间放射治疗后结局的预测因素,为治疗个体化做出贡献。

患者和方法

在 91 名患者中,对病灶数量/部位/直径、Ki-67、MGMT 启动子甲基化、卡诺夫斯基表现评分(KPS)、症状、性别、年龄和切除情况进行评估,以确定局部控制和生存情况。

结果

单因素分析显示,大体切除(p=0.029)与局部控制的改善显著相关。在多因素分析中也具有显著性[风险比(HR)=1.64,p=0.025]。MGMT 甲基化(p=0.004)、KPS≥80(p=0.022)和切除(p<0.001)在单因素分析中与生存的改善显著相关,单灶 GBM(p=0.056)呈趋势。在多因素分析中,MGMT 甲基化(HR=3.63,p=0.009)、KPS(HR=2.01,p=0.018)和切除(HR=3.29,p<0.001)具有显著性。

结论

确定了局部控制和生存的预测因素,这些因素可能有助于医生为 GBM 患者制定个体化治疗方案。

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