TY  - JOUR
AU  - Zeyen, Thomas
AU  - Böhm, Laura
AU  - Paech, Daniel
AU  - Schäfer, Niklas
AU  - Tzaridis, Theophilos
AU  - Duffy, Cathrina
AU  - Nitsch, Louisa
AU  - Schneider, Matthias
AU  - Potthoff, Anna-Laura
AU  - Schneider-Rothhaar, Javen Lennard
AU  - Steinbach, Joachim Peter
AU  - Hau, Peter
AU  - Kowalski, Thomas
AU  - Seidel, Clemens
AU  - Krex, Dietmar
AU  - Grauer, Oliver
AU  - Goldbrunner, Roland
AU  - Zeiner, Pia Susan
AU  - Tabatabai, Ghazaleh
AU  - Galldiks, Norbert
AU  - Stummer, Walter
AU  - Hattingen, Elke
AU  - Glas, Martin
AU  - Gkika, Eleni
AU  - Vatter, Hartmut
AU  - Radbruch, Alexander
AU  - Herrlinger, Ulrich
AU  - Weller, Johannes
AU  - Schaub, Christina
TI  - Quantitative assessment of residual tumor is a strong and independent predictor of survival in methylated glioblastoma following radiochemotherapy with lomustine/temozolomide
JO  - Neuro-Oncology
VL  - 27
IS  - 2
SN  - 1522-8517
CY  - Oxford
PB  - Oxford Univ. Press
M1  - FZJ-2025-00782
SP  - noae205
PY  - 2024
N1  - The CeTeG/NOA-09 trial was funded by the German Ministry for Education and Research.
AB  - 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.
LB  - PUB:(DE-HGF)16
DO  - DOI:10.1093/neuonc/noae205
UR  - https://juser.fz-juelich.de/record/1037611
ER  -