%0 Journal Article
%A Zeyen, Thomas
%A Böhm, Laura
%A Paech, Daniel
%A Schäfer, Niklas
%A Tzaridis, Theophilos
%A Duffy, Cathrina
%A Nitsch, Louisa
%A Schneider, Matthias
%A Potthoff, Anna-Laura
%A Schneider-Rothhaar, Javen Lennard
%A Steinbach, Joachim Peter
%A Hau, Peter
%A Kowalski, Thomas
%A Seidel, Clemens
%A Krex, Dietmar
%A Grauer, Oliver
%A Goldbrunner, Roland
%A Zeiner, Pia Susan
%A Tabatabai, Ghazaleh
%A Galldiks, Norbert
%A Stummer, Walter
%A Hattingen, Elke
%A Glas, Martin
%A Gkika, Eleni
%A Vatter, Hartmut
%A Radbruch, Alexander
%A Herrlinger, Ulrich
%A Weller, Johannes
%A Schaub, Christina
%T Quantitative assessment of residual tumor is a strong and independent predictor of survival in methylated glioblastoma following radiochemotherapy with lomustine/temozolomide
%J Neuro-Oncology
%V 27
%N 2
%@ 1522-8517
%C Oxford
%I Oxford Univ. Press
%M FZJ-2025-00782
%P noae205
%D 2024
%Z The CeTeG/NOA-09 trial was funded by the German Ministry for Education and Research.
%X ackground: Maximum tumor resection improves overall survival (OS) in patients with glioblastoma. The extent of resection (EOR) is historically dichotomized. The RANO resect group recently proposed criteria for volumetry-based EOR assessment in patients that were treated according to Stupp´s protocol. The purpose of this study was (1) to investigate the prognostic value of EOR in patients receiving combined chemotherapy with lomustine (CCNU)/temozolomide (TMZ), and (2) to analyse the prognostic performance of binary EOR assessment compared to volumetric assessment.Methods: 78 patients with newly diagnosed MGMT-methylated GBM undergoing tumor resection followed by radiochemotherapy with CCNU/TMZ were included in this study. Residual contrast-enhancing (CE) tumor volume after the first resection was measured and its influence on OS and PFS was analysed using uni- and multivariable Cox regression analysis as well as two-sided log rank test. Patients were divided into RTV ≤1 cm³, >1 cm³ - ≤5 cm³ and >5 cm³ following the proposed criteria of the RANO resect group.Results: Prolonged OS was associated with age <60 years, low RTV, and gross total resection (GTR). Residual tumor volume (RTV) had a superior prognostic value compared to binary EOR assessment. Patients with total or near total resection of CE tumor (≤1 cm³ RTV) showed prolonged OS (median 54.4 months, 95% CI 46.94-not reached), with a 5-year survival rate of 49%.Conclusion: Low RTV is associated with increased survival in glioblastoma patients undergoing radiochemotherapy with CCNU/TMZ. This study demonstrates the applicability of the recently proposed RANO resect criteria in this subgroup of patients.Keywords: MGMT-promotor; extend of resection; glioblastoma; residual tumor volume.
%F PUB:(DE-HGF)16
%9 Journal Article
%R 10.1093/neuonc/noae205
%U https://juser.fz-juelich.de/record/1037611