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001037611 1001_ $$00009-0006-2919-8622$$aZeyen, Thomas$$b0$$eCorresponding author
001037611 245__ $$aQuantitative assessment of residual tumor is a strong and independent predictor of survival in methylated glioblastoma following radiochemotherapy with lomustine/temozolomide
001037611 260__ $$aOxford$$bOxford Univ. Press$$c2025
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001037611 500__ $$aThe CeTeG/NOA-09 trial was funded by the German Ministry for Education and Research.
001037611 520__ $$aackground: 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.
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001037611 7001_ $$0P:(DE-HGF)0$$aBöhm, Laura$$b1
001037611 7001_ $$0P:(DE-HGF)0$$aPaech, Daniel$$b2
001037611 7001_ $$0P:(DE-HGF)0$$aSchäfer, Niklas$$b3
001037611 7001_ $$0P:(DE-HGF)0$$aTzaridis, Theophilos$$b4
001037611 7001_ $$aDuffy, Cathrina$$b5
001037611 7001_ $$aNitsch, Louisa$$b6
001037611 7001_ $$00000-0002-6025-7479$$aSchneider, Matthias$$b7
001037611 7001_ $$aPotthoff, Anna-Laura$$b8
001037611 7001_ $$aSchneider-Rothhaar, Javen Lennard$$b9
001037611 7001_ $$aSteinbach, Joachim Peter$$b10
001037611 7001_ $$aHau, Peter$$b11
001037611 7001_ $$aKowalski, Thomas$$b12
001037611 7001_ $$aSeidel, Clemens$$b13
001037611 7001_ $$aKrex, Dietmar$$b14
001037611 7001_ $$aGrauer, Oliver$$b15
001037611 7001_ $$aGoldbrunner, Roland$$b16
001037611 7001_ $$aZeiner, Pia Susan$$b17
001037611 7001_ $$00000-0002-3542-8782$$aTabatabai, Ghazaleh$$b18
001037611 7001_ $$0P:(DE-Juel1)143792$$aGalldiks, Norbert$$b19
001037611 7001_ $$00000-0002-3460-0640$$aStummer, Walter$$b20
001037611 7001_ $$aHattingen, Elke$$b21
001037611 7001_ $$00000-0003-3167-3403$$aGlas, Martin$$b22
001037611 7001_ $$aGkika, Eleni$$b23
001037611 7001_ $$aVatter, Hartmut$$b24
001037611 7001_ $$aRadbruch, Alexander$$b25
001037611 7001_ $$aHerrlinger, Ulrich$$b26
001037611 7001_ $$aWeller, Johannes$$b27
001037611 7001_ $$aSchaub, Christina$$b28
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