Cancer Research and Treatment

Original Articles

To Use or Not to Use: Temozolomide in Elderly Patients with IDH Wild-Type MGMT Promoter Unmethylated Glioblastoma Treated with Radiotherapy: Chan Woo Wee, Joo Ho Lee, Hye In Lee, Jina Kim, Jong Hee Chang, Seok-Gu Kang, Eui Hyun Kim, Ju Hyung Moon, Jaeho Cho, Chul-Kee Park, Chae-Yong Kim, Kihwan Hwang, Hong In Yoon, In Ah Kim; Received September 27, 2024 Accepted November 8, 2024 Published online November 11, 2024; DOI: https://doi.org/10.4143/crt.2024.945 [Epub ahead of print]

Abstract PDF PubReader ePub: Purpose
This study aimed to identify a specific subgroup of patients among elderly glioblastoma patients aged 70 years or older with unmethylated O6-methylguanine-DNA methyltransferase promoters (eGBM-unmethylated) who would significantly benefit from the addition of temozolomide (TMZ) to radiotherapy (RT).
Materials and Methods
Newly diagnosed patients with Isocitrate dehydrogenase wild-type eGBM-unmethylated treated with RT were included in this multicenter analysis (n=182). RT dose was 45 Gy in 15 fractions (62.3%), 60 Gy in 30 fractions, or 61.2 Gy in 34 fractions. For patients treated with RT plus TMZ (60.4%), TMZ was administered concurrently with RT, followed by six adjuvant cycles. The primary endpoint was overall survival.
Results
During a median follow-up of 11.3 months for survivors, the median survival was 12.2 months. The median survival duration significantly improved with the addition of TMZ to RT compared with that with RT alone (13.6 months vs. 10.5 months, p=0.028). In the multivariable analysis adjusted for clinical, radiological, and genetic biomarkers, the addition of TMZ significantly improved overall survival (hazard ratio, 0.459; p=0.006). In subgroup analysis, median survival was especially improved by 4-5 months in patients with residual disease (p < 0.001), Karnofsky performance status ≥ 60 (p=0.033), and age ≤ 75 years (p=0.090). A significant benefit of TMZ was noted only in patients with two or three of the above factors (median survival, 14.1 months vs. 10.5 months; p=0.014).
Conclusion
The addition of TMZ significantly improved the survival of patients with eGBM-unmethylated treated with RT. The suggested criteria for the specific subgroup in these patients warrant external validation for clinical application.

1,340 View
70 Download

Central nervous system

Survival, Prognostic Factors, and Volumetric Analysis of Extent of Resection for Anaplastic Gliomas: Je Beom Hong, Tae Hoon Roh, Seok-Gu Kang, Se Hoon Kim, Ju Hyung Moon, Eui Hyun Kim, Sung Soo Ahn, Hye Jin Choi, Jaeho Cho, Chang-Ok Suh, Jong Hee Chang; Cancer Res Treat. 2020;52(4):1041-1049. Published online April 23, 2020; DOI: https://doi.org/10.4143/crt.2020.057

Abstract PDF PubReader ePub

Purpose
The aim of this study is to evaluate the survival rate and prognostic factors of anaplastic gliomas according to the 2016 World Health Organization classification, including extent of resection (EOR) as measured by contrast-enhanced T1-weighted magnetic resonance imaging (MRI) and the T2-weighted MRI.
Materials and Methods
The records of 113 patients with anaplastic glioma who were newly diagnosed at our institute between 2000 and 2013 were retrospectively reviewed. There were 62 cases (54.9%) of anaplastic astrocytoma, isocitrate dehydrogenase (IDH) wild-type (AAw), 18 cases (16.0%) of anaplastic astrocytoma, IDH-mutant, and 33 cases (29.2%) of anaplastic oligodendroglioma, IDH-mutant and 1p/19q-codeleted.
Results
The median overall survival (OS) was 48.4 months in the whole anaplastic glioma group and 21.5 months in AAw group. In multivariate analysis, age, preoperative Karnofsky Performance Scale score, O⁶-methylguanine-DNA methyltransferase (MGMT) methylation status, postoperative tumor volume, and EOR measured from the T2 MRI sequence were significant prognostic factors. The EOR cut-off point for OS measured in contrast-enhanced T1-weighted MRI and T2-weighted MRI were 99.96% and 85.64%, respectively.
Conclusions
We found that complete resection of the contrast-enhanced portion (99.96%) and more than 85.64% resection of the non-enhanced portion of the tumor have prognostic impacts on patient survival from anaplastic glioma.

Citations

Citations to this article as recorded by

AQP1 as a novel biomarker to predict prognosis and tumor immunity in glioma patients
Xiang Gao, Wenqu Jiang, Guofeng Zhu, Zelong Xing, Pengbo Zhu, Zunliang Ke, Qiwei Huang
Oncologie.2024; 26(1): 117. CrossRef
Decapping enzyme 2 is a novel immune-related biomarker that predicts poor prognosis in glioma
Yuran Mei, Qiaoli Lv, Zilong Tan, Zhe Zhang, Yulong Ji, Shuhui Chen, Xiaoli Shen
Biotechnology and Genetic Engineering Reviews.2024; 40(4): 4262. CrossRef
Decision system for extent of resection in WHO grade 3 gliomas: a Chinese Glioma Genome Atlas database analysis
Ziming Hou, Jie Hu, Xing Liu, Zeya Yan, Kenan Zhang, Shengyu Fang, Tao Jiang, Yinyan Wang
Journal of Neuro-Oncology.2023; 164(2): 461. CrossRef
The Impact of Extent of Resection on the Prognosis of Glioblastoma Multiforme: A Systematic Review and Meta-analysis
Dipak Chaulagain, Volodymyr Smolanka, Andriy Smolanka, Sunil Munakomi
Open Access Macedonian Journal of Medical Sciences.2022; 10(F): 345. CrossRef
Relative T2-FLAIR signal intensity surrounding residual cavity is associated with survival prognosis in patients with lower-grade gliomas
Tao Yuan, Zhen Gao, Fei Wang, Jia-Liang Ren, Tianda Wang, Hongbo Zhong, Guodong Gao, Guanmin Quan
Frontiers in Oncology.2022;[Epub] CrossRef
SLC39A1 contribute to malignant progression and have clinical prognostic impact in gliomas
Peng Wang, Jingjing Zhang, Shuai He, Boan Xiao, Xiaobin Peng
Cancer Cell International.2020;[Epub] CrossRef

9,080 View
205 Download
15 Web of Science
6 Crossref

First
Prev
Page of 1
Next
Last

Search