Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Department of Radioneurosurgery, Romodanov Neurosurgery Institute, Kyiv, Ukraine.
Anticancer Res. 2023 Jun;43(6):2725-2732. doi: 10.21873/anticanres.16439.
BACKGROUND/AIM: Standard radiotherapy (RT) for glioblastoma lasts 6 weeks. We aimed to identify patients who would benefit from a hypofractionated approach.
In 167 patients receiving standard fractionation, 10 factors were analyzed for local control (LC) and overall survival (OS). A survival score was developed and compared to a previous instrument.
On multivariate analysis, better LC was significantly associated with the presence of only one lesion and O-methylguanine-DNA methyltransferase (MGMT) promoter methylation. Better OS was associated with one lesion, better performance status, MGMT promoter methylation, and receipt of chemotherapy. Lesion diameter ≤40 mm and upfront resection were associated with improved OS on univariate analyses. Based on assigning scores to these six factors, three groups, with 32-35, 36-44 and 45-48 points, were designed with 12-month OS-rates of 0%, 56%, and 92%, respectively. Accuracy in predicting death within 12 months and survival ≥12 months was 100% and 92%, respectively, versus 67% and 83% with the previous scoring system.
A new survival score with higher accuracy was developed for patients with glioblastoma. Our model can be utilized to individualize RT dose-fractionation recommendations for glioblastoma.
背景/目的：胶质母细胞瘤的标准放疗（RT）持续 6 周。我们旨在确定哪些患者将从低分割方法中受益。
在接受标准分割的 167 名患者中，分析了 10 个因素与局部控制（LC）和总生存（OS）的关系。制定了生存评分并与以前的仪器进行了比较。
多变量分析显示，LC 较好与仅存在一个病变和 O-甲基鸟嘌呤-DNA 甲基转移酶（MGMT）启动子甲基化显著相关。OS 较好与一个病变、较好的表现状态、MGMT 启动子甲基化和接受化疗有关。病变直径≤40mm 和 upfront 切除术与 OS 较好有关。基于对这六个因素进行评分，设计了三个评分组，分别为 32-35、36-44 和 45-48 分，12 个月 OS 率分别为 0%、56%和 92%。与以前的评分系统相比，预测 12 个月内死亡和生存≥12 个月的准确率分别为 100%和 92%。
为胶质母细胞瘤患者开发了一种具有更高准确性的新生存评分。我们的模型可用于个体化胶质母细胞瘤的 RT 剂量分割建议。
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