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@article{1714096,
author = {Lakomý, Radek and Kazda, Tomáš and Selingerová, Iveta and Poprach, Alexandr and Pospíšil, Petr and Belanová, Renata and Fadrus, Pavel and Smrčka, Martin and Vybíhal, Václav and Jančálek, Radim and Kiss, Igor and Múčková, Katarína and Hendrych, Michal and Knight, Andrea and Šána, Jiří and Šlampa, Pavel and Slabý, Ondřej},
article_location = {Basel},
article_number = {9},
doi = {http://dx.doi.org/10.3390/diagnostics10090676},
keywords = {glioblastoma; chemotherapy; radiotherapy; rapid early progression; overall survival},
language = {eng},
issn = {2075-4418},
journal = {Diagnostics},
title = {Pre-Radiotherapy Progression after Surgery of Newly Diagnosed Glioblastoma: Corroboration of New Prognostic Variable},
url = {https://www.mdpi.com/2075-4418/10/9/676},
volume = {10},
year = {2020}
}
TY - JOUR
ID - 1714096
AU - Lakomý, Radek - Kazda, Tomáš - Selingerová, Iveta - Poprach, Alexandr - Pospíšil, Petr - Belanová, Renata - Fadrus, Pavel - Smrčka, Martin - Vybíhal, Václav - Jančálek, Radim - Kiss, Igor - Múčková, Katarína - Hendrych, Michal - Knight, Andrea - Šána, Jiří - Šlampa, Pavel - Slabý, Ondřej
PY - 2020
TI - Pre-Radiotherapy Progression after Surgery of Newly Diagnosed Glioblastoma: Corroboration of New Prognostic Variable
JF - Diagnostics
VL - 10
IS - 9
SP - 1-13
EP - 1-13
PB - MDPI
SN - 20754418
KW - glioblastoma
KW - chemotherapy
KW - radiotherapy
KW - rapid early progression
KW - overall survival
UR - https://www.mdpi.com/2075-4418/10/9/676
L2 - https://www.mdpi.com/2075-4418/10/9/676
N2 - 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.
ER -
LAKOMÝ, Radek, Tomáš KAZDA, Iveta SELINGEROVÁ, Alexandr POPRACH, Petr POSPÍŠIL, Renata BELANOVÁ, Pavel FADRUS, Martin SMRČKA, Václav VYBÍHAL, Radim JANČÁLEK, Igor KISS, Katarína MÚČKOVÁ, Michal HENDRYCH, Andrea KNIGHT, Jiří ŠÁNA, Pavel ŠLAMPA and Ondřej SLABÝ. Pre-Radiotherapy Progression after Surgery of Newly Diagnosed Glioblastoma: Corroboration of New Prognostic Variable. \textit{Diagnostics}. Basel: MDPI, 2020, vol.~10, No~9, p.~1-13. ISSN~2075-4418. Available from: https://dx.doi.org/10.3390/diagnostics10090676.
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