Lazaridis Lazaros, Moenninghoff Christoph, Bumes Elisabeth, Spille Dorothee Cäcilia, Müther Michael, Schulz Tim, Heider Sina, Agkatsev Sarina, Schmidt Teresa, Blau Tobias, Oster Christoph, Stummer Walter, Kessler Almuth Friederike, Seidel Clemens, Grauer Oliver, Hau Peter, Ahmadipour Yahya, Sure Ulrich, Keyvani Kathy, Herrlinger Ulrich, Kleinschnitz Christoph, Stuschke Martin, Guberina Nika, Herrmann Ken, Deuschl Cornelius, Scheffler Björn, Kebir Sied, Glas Martin
Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Division of Clinical Neurooncology, University Medicine Essen, University Duisburg-Essen, Essen, Germany.
German Cancer Consortium (DKTK), Partner Site University Medicine Essen, Essen, Germany.
Cancer Med. 2025 Apr;14(8):e70689. doi: 10.1002/cam4.70689.
Prior research has identified temporal muscle thickness (TMT) as a prognostic marker in glioblastoma. Nonetheless, implementation in daily clinical practice is complicated due to the heterogeneity of previous studies. We performed a multicentric analysis aiming to validate recently proposed sex-specific cutoff values using a homogeneous cohort of newly diagnosed MGMT promoter methylated glioblastoma patients; we included a balanced control cohort for comparison.
TMT was measured at baseline using the initial preoperative/postoperative magnetic resonance images (MRIs) and in disease course using the first MRI after radiotherapy. Patients were divided by sex and TMT into "at risk of sarcopenia" or "normal muscle status." Kaplan-Meier and multivariable Cox regression analysis was used for survival correlation.
In total, n = 126 patients were included (n = 66 treated with CCNU/temozolomide, n = 60 with single-drug temozolomide). Patients with normal muscle mass at baseline had significantly prolonged survival (median overall survival: 44.2 months versus 16.7 months with CCNU/temozolomide, and 29.5 months versus 17.4 months with single-drug temozolomide) compared to those at risk of sarcopenia. In a multivariable Cox regression analysis, normal muscle mass and an initial age at diagnosis of < 50 years emerged as significant prognostic markers. Longitudinally, survival was longest in patients with lack of TMT decline over the disease course.
This analysis confirms TMT as an important prognostic marker in glioblastoma in two real-life cohorts. However, in order to establish TMT assessment as a routine marker for patient selection and therapeutic measures, further validation in prospective controlled trials is necessary.
先前的研究已将颞肌厚度（TMT）确定为胶质母细胞瘤的一个预后标志物。尽管如此，由于先前研究的异质性，其在日常临床实践中的应用仍很复杂。我们进行了一项多中心分析，旨在使用一组新诊断的MGMT启动子甲基化胶质母细胞瘤患者的同质队列来验证最近提出的性别特异性临界值；我们纳入了一个平衡的对照队列进行比较。
在基线时使用初始术前/术后磁共振成像（MRI）测量TMT，并在疾病进程中使用放疗后的首次MRI进行测量。患者按性别和TMT分为“有肌肉减少症风险”或“肌肉状态正常”。采用Kaplan-Meier和多变量Cox回归分析进行生存相关性分析。
总共纳入了n = 126例患者（n = 66例接受洛莫司汀/替莫唑胺治疗，n = 60例接受单药替莫唑胺治疗）。与有肌肉减少症风险的患者相比，基线时肌肉质量正常的患者生存期显著延长（中位总生存期：接受洛莫司汀/替莫唑胺治疗的患者为44.2个月对16.7个月，接受单药替莫唑胺治疗的患者为29.5个月对17.4个月）。在多变量Cox回归分析中，正常肌肉质量和诊断时初始年龄<50岁成为显著的预后标志物。纵向来看，疾病进程中TMT无下降的患者生存期最长。
该分析证实TMT是两个真实队列中胶质母细胞瘤的一个重要预后标志物。然而，为了将TMT评估确立为患者选择和治疗措施的常规标志物，有必要在前瞻性对照试验中进行进一步验证。
