Analysis of Patients with Glioblastoma Treated with Standard 6-Week Chemoradiation Followed by Temozolomide: Treatment Outcomes and Prognostic Factors

<i>Background and Objectives</i>: We aimed to investigate the treatment outcomes and prognostic factors of survival among patients with glioblastoma who underwent 6-week concurrent chemoradiation therapy (CCRT) followed by temozolomide (TMZ) with Stupp’s regimen in a single tertiary inst...

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Main Authors: Sojung Lee, Myungsoo Kim
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/3/376
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author Sojung Lee
Myungsoo Kim
author_facet Sojung Lee
Myungsoo Kim
author_sort Sojung Lee
collection DOAJ
description <i>Background and Objectives</i>: We aimed to investigate the treatment outcomes and prognostic factors of survival among patients with glioblastoma who underwent 6-week concurrent chemoradiation therapy (CCRT) followed by temozolomide (TMZ) with Stupp’s regimen in a single tertiary institution. <i>Materials and Methods</i>: Eighty patients with glioblastoma who underwent 6-week CCRT followed by TMZ between June 2010 and January 2024 were retrospectively investigated. A survival analysis was performed of factors such as age, O (6)-methylguanine-DNA methyltransferase promoter (MGMT) methylation, extent of resection, pre- and post-operative Karnofsky Performance Status, and inflammatory markers such as neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio. Post-operative inflammatory markers were assessed at 2–3 weeks post-operative before the initiation of CCRT. A subgroup analysis was performed of patients who underwent non-gross total resection (GTR). <i>Results</i>: The median progression-free survival (PFS) and overall survival (OS) of the entire cohort were 8.97 months and 19.0 months, respectively. Older age (≥65 years) and non-GTR status were adverse prognostic factors of PFS and OS. MGMT methylation is a favorable prognostic factor for PFS and OS. In the subgroup of patients who underwent non-GTR, MGMT methylation and post-operative LMR (<3.2/>3.2) were independent prognostic factors for PFS and OS. <i>Conclusions</i>: As with previous studies, older age, MGMT methylation, and extent of resection were independent prognostic factors for the survival of patients with glioblastoma who underwent standard treatment with Stupp’s regimen. MGMT methylation and post-operative LMR were significant prognostic factors for PFS and OS among patients who underwent non-GTR. The prognostic significance of post-operative inflammatory markers for treatment response and survival should be further validated in glioblastoma patients treated with Stupp’s regimen.
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spelling doaj-art-0295c7ac16224b3d9c83f643df4f45752025-08-20T03:43:10ZengMDPI AGMedicina1010-660X1648-91442025-02-0161337610.3390/medicina61030376Analysis of Patients with Glioblastoma Treated with Standard 6-Week Chemoradiation Followed by Temozolomide: Treatment Outcomes and Prognostic FactorsSojung Lee0Myungsoo Kim1Department of Radiation Oncology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Radiation Oncology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea<i>Background and Objectives</i>: We aimed to investigate the treatment outcomes and prognostic factors of survival among patients with glioblastoma who underwent 6-week concurrent chemoradiation therapy (CCRT) followed by temozolomide (TMZ) with Stupp’s regimen in a single tertiary institution. <i>Materials and Methods</i>: Eighty patients with glioblastoma who underwent 6-week CCRT followed by TMZ between June 2010 and January 2024 were retrospectively investigated. A survival analysis was performed of factors such as age, O (6)-methylguanine-DNA methyltransferase promoter (MGMT) methylation, extent of resection, pre- and post-operative Karnofsky Performance Status, and inflammatory markers such as neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio. Post-operative inflammatory markers were assessed at 2–3 weeks post-operative before the initiation of CCRT. A subgroup analysis was performed of patients who underwent non-gross total resection (GTR). <i>Results</i>: The median progression-free survival (PFS) and overall survival (OS) of the entire cohort were 8.97 months and 19.0 months, respectively. Older age (≥65 years) and non-GTR status were adverse prognostic factors of PFS and OS. MGMT methylation is a favorable prognostic factor for PFS and OS. In the subgroup of patients who underwent non-GTR, MGMT methylation and post-operative LMR (<3.2/>3.2) were independent prognostic factors for PFS and OS. <i>Conclusions</i>: As with previous studies, older age, MGMT methylation, and extent of resection were independent prognostic factors for the survival of patients with glioblastoma who underwent standard treatment with Stupp’s regimen. MGMT methylation and post-operative LMR were significant prognostic factors for PFS and OS among patients who underwent non-GTR. The prognostic significance of post-operative inflammatory markers for treatment response and survival should be further validated in glioblastoma patients treated with Stupp’s regimen.https://www.mdpi.com/1648-9144/61/3/376glioblastomaconcurrent chemoradiationinflammatory markerprognostic factor
spellingShingle Sojung Lee
Myungsoo Kim
Analysis of Patients with Glioblastoma Treated with Standard 6-Week Chemoradiation Followed by Temozolomide: Treatment Outcomes and Prognostic Factors
Medicina
glioblastoma
concurrent chemoradiation
inflammatory marker
prognostic factor
title Analysis of Patients with Glioblastoma Treated with Standard 6-Week Chemoradiation Followed by Temozolomide: Treatment Outcomes and Prognostic Factors
title_full Analysis of Patients with Glioblastoma Treated with Standard 6-Week Chemoradiation Followed by Temozolomide: Treatment Outcomes and Prognostic Factors
title_fullStr Analysis of Patients with Glioblastoma Treated with Standard 6-Week Chemoradiation Followed by Temozolomide: Treatment Outcomes and Prognostic Factors
title_full_unstemmed Analysis of Patients with Glioblastoma Treated with Standard 6-Week Chemoradiation Followed by Temozolomide: Treatment Outcomes and Prognostic Factors
title_short Analysis of Patients with Glioblastoma Treated with Standard 6-Week Chemoradiation Followed by Temozolomide: Treatment Outcomes and Prognostic Factors
title_sort analysis of patients with glioblastoma treated with standard 6 week chemoradiation followed by temozolomide treatment outcomes and prognostic factors
topic glioblastoma
concurrent chemoradiation
inflammatory marker
prognostic factor
url https://www.mdpi.com/1648-9144/61/3/376
work_keys_str_mv AT sojunglee analysisofpatientswithglioblastomatreatedwithstandard6weekchemoradiationfollowedbytemozolomidetreatmentoutcomesandprognosticfactors
AT myungsookim analysisofpatientswithglioblastomatreatedwithstandard6weekchemoradiationfollowedbytemozolomidetreatmentoutcomesandprognosticfactors