Zha Boya, Ma Yajing, Zha Boqun, Guo Xinbin
Department of Radiotherapy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Neurointervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Eur Radiol. 2025 Jan 31. doi: 10.1007/s00330-025-11394-7.
This study aims to investigate the prognostic value of Temporal Muscle Thickness (TMT) in Chinese patients with newly diagnosed isocitrate dehydrogenase (IDH) wild-type glioblastoma.
Data were retrospectively collected from patients with isocitrate dehydrogenase wild-type genotype glioblastoma, who underwent surgical treatment and concurrent chemoradiotherapy at our center between May 2019 and May 2023. Multi-model and multivariate Cox regression were used to examine factors associated with overall and progression-free survival. Subgroup analysis and sensitivity tests were performed to verify the robustness of the results. Restricted cubic spline regression was used to explore the possible nonlinear relationship between TMT and OS/PFS.
A total of 344 patients were enrolled in this study. The main analysis showed that TMT was positively correlated with overall survival and progression-free survival. The results of multivariate Cox regression after segmentation according to the optimal cutoff value showed that age ≥ 60 years (HR = 1.47, 95% CI: 1.14-1.90, p = 0.003), diabetes (HR = 1.95, 95% CI: 1.26-3.04, p = 0.003) were the risk factors for death. However, TMT ≥ 8.425 mm (HR = 0.45, 95% CI: 0.36-0.57, p < 0.001), Karnofsky ≥ 70 (HR = 0.76, 95% CI: 0.59-0.97, p < 0.031) were associated with a lower risk of death. Age ≥ 60 years (HR = 1.33, 95% CI: 1.03-1.71, p = 0.028) was a risk factor for recurrence, Karnofsky ≥ 70 (HR = 0.76, 95% CI: 0.59-0.97, p = 0.027), TMT ≥ 8.4 mm (HR = 0.64, 95% CI: 0.50-0.80, p < 0.001), and combination of targeted therapy (HR = 0.65, 95% CI: 0.47-0.90, p = 0.01) reduced recurrence risk.
TMT is an independent predictor of OS and PFS in IDH wild-type GBM patients and can be used to predict prognosis in clinical practice.
Question Performance status of glioblastoma patients is crucial for treatment decision-making and prognosis assessment; however, there is currently no objective evaluation metric for the Chinese population. Findings Temporal muscle thickness at initial diagnosis is positively correlated with overall survival and progression-free survival in Chinese patients with newly diagnosed IDH wild-type glioblastoma. Clinical relevance Temporal muscle thickness at initial diagnosis is an independent, objective prognostic factor for newly diagnosed IDH wild-type glioblastoma patients in China. It contributes to the formulation of individualized treatment plans and serves as a stratification factor in clinical trials.
本研究旨在探讨颞肌厚度（TMT）对中国新诊断的异柠檬酸脱氢酶（IDH）野生型胶质母细胞瘤患者的预后价值。
回顾性收集2019年5月至2023年5月在本中心接受手术治疗及同步放化疗的IDH野生型基因型胶质母细胞瘤患者的数据。采用多模型和多变量Cox回归分析与总生存和无进展生存相关的因素。进行亚组分析和敏感性检验以验证结果的稳健性。采用限制立方样条回归探索TMT与总生存/无进展生存之间可能的非线性关系。
本研究共纳入344例患者。主要分析显示，TMT与总生存和无进展生存呈正相关。根据最佳临界值进行分层后的多变量Cox回归结果显示，年龄≥60岁（HR = 1.47，95%CI：1.14 - 1.90，p = 0.003）、糖尿病（HR = 1.95，95%CI：1.26 - 3.04，p = 0.003）是死亡的危险因素。然而，TMT≥8.425mm（HR = 0.45，95%CI：0.36 - 0.57，p < 0.001）、卡氏评分≥70（HR = 0.76，95%CI：0.59 - 0.97，p < 0.031）与较低的死亡风险相关。年龄≥60岁（HR = 1.33，95%CI：1.03 - 1.71，p = 0.028）是复发的危险因素，卡氏评分≥70（HR = 0.76，95%CI：0.59 - 0.97，p = 0.027）、TMT≥8.4mm（HR = 0.64，95%CI：0.50 - 0.80，p < 0.001）以及联合靶向治疗（HR = 0.65，95%CI：0.47 - 0.90，p = 0.01）可降低复发风险。
TMT是IDH野生型胶质母细胞瘤患者总生存和无进展生存的独立预测指标，可用于临床实践中的预后预测。
问题胶质母细胞瘤患者的功能状态对于治疗决策和预后评估至关重要；然而，目前中国人群尚无客观的评估指标。发现初诊时的颞肌厚度与中国新诊断的IDH野生型胶质母细胞瘤患者的总生存和无进展生存呈正相关。临床意义初诊时的颞肌厚度是中国新诊断的IDH野生型胶质母细胞瘤患者独立、客观的预后因素。它有助于制定个体化治疗方案，并在临床试验中作为分层因素。
