Association of pre-radiotherapy tumour burden and overall survival in newly diagnosed glioblastoma adjusted for MGMT promoter methylation status

• DOI: 10.1016/j.ejca.2023.04.021
• Publication Date: 2023-04-28T16:12:34Z
• Authors: A. Alafandi; K.A. van Garderen; S. Klein; S.R. van der Voort; D. Rizopoulos; L. Nabors; R. Stupp; M. Weller; T. Gorlia; J.-C. Tonn; M. Smits
• Keywords: Temozolomide; Chemoradiotherapy; O-6-methylguanine-DNA methyltransferase; Performance status

PurposeWe retrospectively evaluated the association between postoperative pre-radiotherapy tumour burden and overall survival (OS) adjusted for prognostic value of O6-methylguanine DNA methyltransferase (MGMT) promoter methylation in patients with newly diagnosed glioblastoma treated radio-/chemotherapy temozolomide.Materials methodsPatients were included from CENTRIC (EORTC 26071-22072) CORE trials if magnetic resonance imaging scans available within a timeframe up to 4 weeks before radiotherapy, including both pre- post-contrast T1w images at least one T2w sequence (T2w or T2w-FLAIR). Postoperative (residual) contrast-enhanced (CET) volumes non-enhanced abnormalities (NT2A) tissue obtained by three-dimensional segmentation. Cox proportional hazard models Kaplan Meier estimates used assess CET/NT2A volume OS known factors (age, performance status, MGMT status).Results408 (of which 270 methylated) segmentations included. Median methylated tumours was 117 versus 61 unmethylated (p < 0.001). When stratified higher CET (HR 1.020; 95% confidence interval CI [1.013–1.027]; p 0.001) older age 1.664; [1.214–2.281]; = 0.002) significantly associated shorter while NT2A status not.ConclusionPre-radiotherapy strongly receiving status.