Classification of Progression Patterns in Glioblastoma: Analysis of Predictive Factors and Clinical Implications.
Classification of Progression Patterns in Glioblastoma: Analysis of Predictive Factors and Clinical Implications.
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胶质母细胞瘤进展模式的分类：预测因素和临床意义分析
DOI：
10.3389/fonc.2020.590648
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发表时间：
2020
影响因子：
4.7
通讯作者：
Lin S
中科院分区：
文献类型：
--
作者：
Jiang H;Yu K;Li M;Cui Y;Ren X;Yang C;Zhao X;Lin S
背景本研究旨在探讨 IDH 野生型胶质母细胞瘤 (GBM) 放化疗后首次复发时的进展模式。方法 回顾性分析 247 例 IDH 野生型 GBM 诊断后病情进展的患者的记录。根据术前和术后连续放射线图像，进展模式被分为局部、远处、室管膜下或软脑膜播散。分析了不同进展模式的临床和分子特征。结果 共有186例（75.3%）患者出现局部进展，15例（6.1%）例出现远处进展，33例（13.3%）例出现室管膜下播散，13例（5.3%）例出现软脑膜播散。局部进展的患者生存率最高，而远处进展、室管膜下或软脑膜播散的患者则被重新分类为非局部组，生存率没有显着差异。多变量分析显示化疗是非局部进展的保护因素，而性别、男性、室下区（SVZ）受累和O6-甲基鸟嘌呤-DNA-甲基转移酶（MGMT）启动子甲基化被证实是非局部进展的危险因素（P < 0.05）。基于多变量分析筛选的因素，构建了列线图，该列线图在预测非局部进展方面具有较高的准确性。非本地组患者可分为长期生存者和短期生存者，其SVZ受累率、MGMT启动子甲基化率和再照射率存在差异（P < 0.05），整合这些因素的列线图显示出预测长期生存者的较高准确性。结论 具有不同进展模式的患者具有不同的临床和分子特征。我们的列线图可以为医生做出更加个性化和精确的治疗决策提供理论参考。
Background This study was designed to explore the progression patterns of IDH-wildtype glioblastoma (GBM) at first recurrence after chemoradiotherapy. Methods Records from 247 patients who underwent progression after diagnosis of IDH-wildtype GBM was retrospectively reviewed. Progression patterns were classified as either local, distant, subependymal or leptomeningeal dissemination based on the preoperative and serial postoperative radiographic images. The clinical and molecular characteristics of different progression patterns were analyzed. Results A total of 186 (75.3%) patients had local progression, 15 (6.1%) patients had distant progression, 33 (13.3%) patients had subependymal dissemination, and 13 (5.3%) patients had leptomeningeal dissemination. The most favorable survival occurred in patients with local progression, while no significant difference of survival was found among patients with distant progression, subependymal or leptomeningeal dissemination who were thereby reclassified into non-local group. Multivariable analysis showed that chemotherapy was a protective factor for non-local progression, while gender of male, subventricular zone (SVZ) involvement and O6-methylguanine-DNA-methyltransferase (MGMT) promoter methylation were confirmed as risk factors for non-local progression (P < 0.05). Based on the factors screened by multivariable analysis, a nomogram was constructed which conferred high accuracy in predicting non-local progression. Patients in non-local group could be divided into long- and short-term survivors who differed in the rates of SVZ involvement, MGMT promoter methylation and reirradiation (P < 0.05), and a nomogram integrating these factors showed high accuracy in predicting long-term survivors. Conclusion Patients harboring different progression patterns conferred distinct clinical and molecular characteristics. Our nomograms could provide theoretical references for physicians to make more personalized and precise treatment decisions.
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影响因子：
5.7
作者：
Niyazi, Maximilian;Schnell, Oliver;la Fougere, Christian
通讯作者：
la Fougere, Christian
DOI：
10.1016/j.radonc.2015.07.032
发表时间：
2015-08
期刊：
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
影响因子：
--
作者：
Chen L;Chaichana KL;Kleinberg L;Ye X;Quinones-Hinojosa A;Redmond K
通讯作者：
Redmond K
DOI：
10.1111/j.1754-9485.2010.02232.x
发表时间：
2011-02-01
影响因子：
1.6
作者：
Dobelbower, Michael C.;Burnett, Omer L., III;Fiveash, John B.
通讯作者：
Fiveash, John B.
影响因子：
15.9
作者：
Jafri, Nazia F.;Clarke, Jennifer L.;Cha, Soonmee
通讯作者：
Cha, Soonmee
DOI：
10.1016/j.ijrobp.2006.12.009
发表时间：
2007-05-01
影响因子：
7
作者：
Chang, Eric L.;Akyurek, Serap;Maor, Moshe H.
通讯作者：
Maor, Moshe H.