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The Role of Delayed Radiotherapy Initiation in Patients with Newly Diagnosed Glioblastoma with Residual Tumor Mass.
- Source :
-
Journal of neurological surgery. Part A, Central European neurosurgery [J Neurol Surg A Cent Eur Neurosurg] 2022 May; Vol. 83 (3), pp. 252-258. Date of Electronic Publication: 2021 Sep 08. - Publication Year :
- 2022
-
Abstract
- Objective: Treatment for newly diagnosed isocitrate dehydrogenase (IDH) wild-type glioblastoma (GBM) includes maximum safe resection, followed by adjuvant radio(chemo)therapy (RCx) with temozolomide. There is evidence that it is safe for GBM patients to prolong time to irradiation over 4 weeks after surgery. This study aimed at evaluating whether this applies to GBM patients with different levels of residual tumor volume (RV).<br />Methods: Medical records of all patients with newly diagnosed GBM at our department between 2014 and 2018 were reviewed. Patients who received adjuvant radio (chemo) therapy, aged older than 18 years, and with adequate perioperative imaging were included. Initial and residual tumor volumes were determined. Time to irradiation was dichotomized into two groups (≤28 and >28 days). Univariate analysis with Kaplan-Meier estimate and log-rank test was performed. Survival prediction and multivariate analysis were performed employing Cox proportional hazard regression.<br />Results: One hundred and twelve patients were included. Adjuvant treatment regimen, extent of resection, residual tumor volume, and O <superscript>6</superscript> -methylguanine DNA methyltransferase (MGMT) promoter methylation were statistically significant factors for overall survival (OS). Time to irradiation had no impact on progression-free survival ( p = 0.946) or OS ( p = 0.757). When stratified for different thresholds of residual tumor volume, survival predication via Cox regression favored time to irradiation below 28 days for patients with residual tumor volume above 2 mL, but statistical significance was not reached.<br />Conclusion: Time to irradiation had no significant influence on OS of the entire cohort. Nevertheless, a statistically nonsignificant survival prolongation could be observed in patients with residual tumor volume > 2 mL when admitted to radiotherapy within 28 days after surgery.<br />Competing Interests: None declared.<br /> (Thieme. All rights reserved.)
- Subjects :
- Antineoplastic Agents, Alkylating therapeutic use
Biomarkers, Tumor genetics
Biomarkers, Tumor therapeutic use
DNA Methylation
DNA Repair Enzymes genetics
Humans
Neoplasm, Residual radiotherapy
O(6)-Methylguanine-DNA Methyltransferase genetics
O(6)-Methylguanine-DNA Methyltransferase therapeutic use
Prognosis
Brain Neoplasms diagnostic imaging
Brain Neoplasms radiotherapy
Glioblastoma diagnostic imaging
Glioblastoma radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 2193-6323
- Volume :
- 83
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of neurological surgery. Part A, Central European neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 34496417
- Full Text :
- https://doi.org/10.1055/s-0041-1730965