Paradoxical Association Between Relative Cerebral Blood Volume Dynamics Following Chemoradiation and Increased Progression-Free Survival in Newly Diagnosed IDH Wild-Type MGMT Promoter Methylated Glioblastoma With Measurable Disease.
Paradoxical Association Between Relative Cerebral Blood Volume Dynamics Following Chemoradiation and Increased Progression-Free Survival in Newly Diagnosed IDH Wild-Type MGMT Promoter Methylated Glioblastoma With Measurable Disease.
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DOI：
10.3389/fonc.2022.849993
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发表时间：
2022
影响因子：
4.7
通讯作者：
Ellingson BM
中科院分区：
文献类型：
--
作者：
Goldman J;Hagiwara A;Yao J;Raymond C;Ong C;Bakhti R;Kwon E;Farhat M;Torres C;Erickson LG;Curl BJ;Lee M;Pope WB;Salamon N;Nghiemphu PL;Ji M;Eldred BS;Liau LM;Lai A;Cloughesy TF;Chung C;Ellingson BM
虽然相对脑血容量（rCBV）可能是胶质母细胞瘤（GBM）生存的诊断和预后指标，但尚未探讨新诊断GBM亚群接受次全切除术后放化疗期间rCBV的变化以及MGMT启动子甲基化状态对生存的影响。本研究旨在研究rCBV反应、MGMT甲基化状态与新诊断的具有可测量增强病变的GBM的无进展（PFS）和总生存期（OS）之间的相关性。筛选了1，153名新诊断的IDH野生型GBM患者，53名患者（4.6%）具有可测量的术后肿瘤（> 1 mL）。在患者接受放化疗之前和之后测量rCBV。rCBV降低>10%的患者被认为是rCBV应答者，而rCBV升高或降低<10%的患者被认为是rCBV无应答者。探讨了肿瘤体积增加、rCBV变化、MGMT启动子甲基化状态与PFS或OS之间的关系。放化疗后肿瘤体积的减小有延长OS的趋势（p=0.12;中位OS=26.8 vs 16.3个月）。巧合的是，与应答者相比，rCBV无应答者的PFS显著改善（p=0.047;中位PFS=9.6 vs 7.2个月）。与MGMT未甲基化rCBV无应答者相比，MGMT甲基化rCBV无应答者表现出显著更长的PFS（p<0.001;中位PFS=0.5 vs. 7.1个月），并且与甲基化rCBV应答者相比，MGMT甲基化rCBV无应答者倾向于更长的PFS（p=0.089;中位PFS=20.5 vs. 13.8个月）。该初步报告表明，在新诊断的IDH野生型GBM中，手术后有可测量的增强疾病（5%的患者），rCBV的神秘无应答与PFS延长相关，特别是在MGMT甲基化患者中。
While relative cerebral blood volume (rCBV) may be diagnostic and prognostic for survival in glioblastoma (GBM), changes in rCBV during chemoradiation in the subset of newly diagnosed GBM with subtotal resection and the impact of MGMT promoter methylation status on survival have not been explored. This study aimed to investigate the association between rCBV response, MGMT methylation status, and progression-free (PFS) and overall survival (OS) in newly diagnosed GBM with measurable enhancing lesions. 1,153 newly diagnosed IDH wild-type GBM patients were screened and 53 patients (4.6%) had measurable post-surgical tumor (>1mL). rCBV was measured before and after patients underwent chemoradiation. Patients with a decrease in rCBV >10% were considered rCBV Responders, while patients with an increase or a decrease in rCBV <10% were considered rCBV Non-Responders. The association between change in enhancing tumor volume, change in rCBV, MGMT promotor methylation status, and PFS or OS were explored. A decrease in tumor volume following chemoradiation trended towards longer OS (p=0.12; median OS=26.8 vs. 16.3 months). Paradoxically, rCBV Non-Responders had a significantly improved PFS compared to Responders (p=0.047; median PFS=9.6 vs. 7.2 months). MGMT methylated rCBV Non-Responders exhibited a significantly longer PFS compared to MGMT unmethylated rCBV Non-Responders (p<0.001; median PFS=0.5 vs. 7.1 months), and MGMT methylated rCBV Non-Responders trended towards longer PFS compared to methylated rCBV Responders (p=0.089; median PFS=20.5 vs. 13.8 months). This preliminary report demonstrates that in newly diagnosed IDH wild-type GBM with measurable enhancing disease after surgery (5% of patients), an enigmatic non-response in rCBV was associated with longer PFS, particularly in MGMT methylated patients.
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影响因子：
158.5
作者：
Stupp, R;Mason, WP;Ryan, G
通讯作者：
Ryan, G
影响因子：
4.8
作者：
Seeger, Achim;Braun, Christian;Bisdas, Sotirios
通讯作者：
Bisdas, Sotirios
影响因子：
3
作者：
Grossman, Rachel;Tyler, Betty;Brem, Henry
通讯作者：
Brem, Henry
影响因子：
3.5
作者：
Leu, K.;Boxerman, J. L.;Ellingson, B. M.
通讯作者：
Ellingson, B. M.
影响因子：
2.5
作者：
Larsson, Christopher;Groote, Inge;Bjornerud, Atle
通讯作者：
Bjornerud, Atle