Götz Linda, Ansafi Tananeh, Gerken Michael, Klinkhammer-Schalke Monika, Fischl Anna, Riemenschneider Markus J, Proescholdt Martin, Bumes Elisabeth, Kölbl Oliver, Schmidt Nils Ole, Linker Ralf, Hau Peter, Haedenkamp Tareq M
Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany.
Center for Quality Assurance and Health Services Research, University of Regensburg, Regensburg, Germany.
Neurooncol Adv. 2024 Oct 4;6(1):vdae170. doi: 10.1093/noajnl/vdae170. eCollection 2024 Jan-Dec.
Glioblastoma (GB) is the most frequent malignant brain tumor and has a dismal prognosis. In other cancers, antibiotic use has been associated with severity of chemotherapy-induced toxicity and outcome. We investigated if these mechanisms are also involved in GB.
We selected a cohort of 78 GB patients who received combined radiochemotherapy. We investigated if exposure to prediagnostic antibiotic use is associated with clinical side effects and laboratory changes during adjuvant therapy as well as overall survival (OS) and progression-free survival (PFS) using chi-square test, binary logistic regression, Kaplan-Meyer analysis, and multivariable Cox regression.
Seventeen patients (21.8%) received at least one course of prediagnostic antibiotics and 61 (78.2%) received no antibiotics. We found a higher incidence of loss of appetite (23.5% vs. 4.9%; = .018) and myelosuppression (41.2% vs. 18.0%; = .045) in the antibiotic group. Multivariable logistic regression analysis revealed antibiotics to be a predictor for nausea (OR = 6.94, 95% CI: 1.09-44.30; = .041) and myelosuppression (OR = 9.75, 95% CI: 1.55-61.18; = .015). Furthermore, lymphocytopenia was more frequent in the antibiotic group (90.0% vs. 56.1%, = .033). There were no significant differences in OS ( = .404) and PFS ( = .844). Multivariable Cox regression showed a trend toward shorter survival time ( = .089) in the antibiotic group.
Our study suggests that antibiotic use affects symptoms and lab values in GB patients. Larger prospective studies are required to investigate if prediagnostic antibiotic use could be a prognostic factor in GB patients.
胶质母细胞瘤（GB）是最常见的恶性脑肿瘤，预后较差。在其他癌症中，抗生素的使用与化疗诱导的毒性严重程度及预后相关。我们研究了这些机制是否也与胶质母细胞瘤有关。
我们选取了78例接受联合放化疗的胶质母细胞瘤患者队列。我们使用卡方检验、二元逻辑回归、Kaplan-Meier分析和多变量Cox回归，研究诊断前使用抗生素是否与辅助治疗期间的临床副作用和实验室变化以及总生存期（OS）和无进展生存期（PFS）相关。
17例患者（21.8%）接受了至少一个疗程的诊断前抗生素治疗，61例（78.2%）未使用抗生素。我们发现抗生素组食欲减退的发生率更高（23.5%对4.9%；P = 0.018），骨髓抑制的发生率也更高（41.2%对18.0%；P = 0.045）。多变量逻辑回归分析显示，抗生素是恶心（OR = 6.94，95%CI：1.09 - 44.30；P = 0.041）和骨髓抑制（OR = 9.75，95%CI：1.55 - 61.18；P = 0.015）的一个预测因素。此外，抗生素组淋巴细胞减少更为常见（90.0%对56.1%，P = 0.033）。总生存期（P = 0.404）和无进展生存期（P = 0.844）无显著差异。多变量Cox回归显示抗生素组生存时间有缩短趋势（P = 0.089）。
我们的研究表明，抗生素的使用会影响胶质母细胞瘤患者的症状和实验室检查值。需要更大规模的前瞻性研究来调查诊断前使用抗生素是否可能是胶质母细胞瘤患者的一个预后因素。
