Pre-Radiotherapy Progression after Surgery of Newly Diagnosed
Glioblastoma: Corroboration of New Prognostic Variable

J 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.

Basic information

Original name

Pre-Radiotherapy Progression after Surgery of Newly Diagnosed Glioblastoma: Corroboration of New Prognostic Variable

Authors

LAKOMÝ, Radek (203 Czech Republic, belonging to the institution), Tomáš KAZDA (203 Czech Republic, guarantor, belonging to the institution), Iveta SELINGEROVÁ (203 Czech Republic), Alexandr POPRACH (203 Czech Republic, belonging to the institution), Petr POSPÍŠIL (203 Czech Republic, belonging to the institution), Renata BELANOVÁ (203 Czech Republic, belonging to the institution), Pavel FADRUS (203 Czech Republic, belonging to the institution), Martin SMRČKA (203 Czech Republic, belonging to the institution), Václav VYBÍHAL (203 Czech Republic, belonging to the institution), Radim JANČÁLEK (203 Czech Republic, belonging to the institution), Igor KISS (203 Czech Republic, belonging to the institution), Katarína MÚČKOVÁ (703 Slovakia, belonging to the institution), Michal HENDRYCH (203 Czech Republic, belonging to the institution), Andrea KNIGHT (203 Czech Republic, belonging to the institution), Jiří ŠÁNA (203 Czech Republic, belonging to the institution), Pavel ŠLAMPA (203 Czech Republic, belonging to the institution) and Ondřej SLABÝ (203 Czech Republic, belonging to the institution)

Edition

Diagnostics, Basel, MDPI, 2020, 2075-4418

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30218 General and internal medicine

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.706

RIV identification code

RIV/00216224:14110/20:00118634

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.3390/diagnostics10090676

UT WoS

000580070800001

Keywords in English

glioblastoma; chemotherapy; radiotherapy; rapid early progression; overall survival

Abstract

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.

Links

NV19-05-00410, research and development project

Name: Úloha cytotoxických gamma-delta T buněk na terapeutické rezistenci a recidivě Glioblastoma Multiforme

Investor: Ministry of Health of the CR

Citovat

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. Diagnostics. Basel: MDPI, 2020, vol. 10, No 9, p. 1-13. ISSN 2075-4418. Available from: https://dx.doi.org/10.3390/diagnostics10090676.

@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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