2020
Pre-Radiotherapy Progression after Surgery of Newly Diagnosed Glioblastoma: Corroboration of New Prognostic Variable
LAKOMÝ, Radek, Tomáš KAZDA, Iveta SELINGEROVÁ, Alexandr POPRACH, Petr POSPÍŠIL et. al.Základní údaje
Originální název
Pre-Radiotherapy Progression after Surgery of Newly Diagnosed Glioblastoma: Corroboration of New Prognostic Variable
Autoři
LAKOMÝ, Radek (203 Česká republika, domácí), Tomáš KAZDA (203 Česká republika, garant, domácí), Iveta SELINGEROVÁ (203 Česká republika), Alexandr POPRACH (203 Česká republika, domácí), Petr POSPÍŠIL (203 Česká republika, domácí), Renata BELANOVÁ (203 Česká republika, domácí), Pavel FADRUS (203 Česká republika, domácí), Martin SMRČKA (203 Česká republika, domácí), Václav VYBÍHAL (203 Česká republika, domácí), Radim JANČÁLEK (203 Česká republika, domácí), Igor KISS (203 Česká republika, domácí), Katarína MÚČKOVÁ (703 Slovensko, domácí), Michal HENDRYCH (203 Česká republika, domácí), Andrea KNIGHT (203 Česká republika, domácí), Jiří ŠÁNA (203 Česká republika, domácí), Pavel ŠLAMPA (203 Česká republika, domácí) a Ondřej SLABÝ (203 Česká republika, domácí)
Vydání
Diagnostics, Basel, MDPI, 2020, 2075-4418
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30218 General and internal medicine
Stát vydavatele
Švýcarsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 3.706
Kód RIV
RIV/00216224:14110/20:00118634
Organizační jednotka
Lékařská fakulta
UT WoS
000580070800001
Klíčová slova anglicky
glioblastoma; chemotherapy; radiotherapy; rapid early progression; overall survival
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 14. 1. 2021 14:57, Mgr. Tereza Miškechová
Anotace
V originále
Background: The aim of this retrospective study is to assess the incidence, localization, and potential predictors of rapid early progression (REP) prior to initiation of radiotherapy in newly diagnosed glioblastoma patients and to compare survival outcomes in cohorts with or without REP in relation to the treatment. Methods: We assessed a consecutive cohort of 155 patients with histologically confirmed irradiated glioblastoma from 1/2014 to 12/2017. A total of 90 patients with preoperative, postoperative, and planning MRI were analyzed. Results: Median age 59 years, 59% men, and 39 patients (43%) underwent gross total tumor resection. The Stupp regimen was indicated to 64 patients (71%); 26 patients (29%) underwent radiotherapy alone. REP on planning MRI performed shortly prior to radiotherapy was found in 46 (51%) patients, most often within the surgical cavity wall, and the main predictor for REP was non-radical surgery (p < 0.001). The presence of REP was confirmed as a strong negative prognostic factor; median overall survival (OS) in patients with REP was 10.7 vs. 18.7 months and 2-year survival was 15.6% vs. 37.7% (hazard ratio HR 0.53 for those without REP;p= 0.007). Interestingly, the REP occurrence effect on survival outcome was significantly different in younger patients (<= 50 years) and older patients (> 50 years) for OS (p= 0.047) and non-significantly for PFS (p= 0.341). In younger patients, REP was a stronger negative prognostic factor, probably due to more aggressive behavior. Patients with REP who were indicated for the Stupp regimen had longer OS compared to radiotherapy alone (median OS 16.0 vs 7.5; HR = 0.5,p= 0.022; 2-year survival 22.3% vs. 5.6%). The interval between surgery and the initiation of radiotherapy were not prognostic in either the entire cohort or in patients with REP. Conclusion: Especially in the subgroup of patients without radical resection, one may recommend as early initiation of radiotherapy as possible. The phenomenon of REP should be recognized as an integral part of stratification factors in future prospective clinical trials enrolling patients before initiation of radiotherapy.
Návaznosti
NV19-05-00410, projekt VaV |
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