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@ARTICLE{Zeyen:1037611,
      author       = {Zeyen, Thomas and Böhm, Laura and Paech, Daniel and
                      Schäfer, Niklas and Tzaridis, Theophilos and Duffy,
                      Cathrina and Nitsch, Louisa and Schneider, Matthias and
                      Potthoff, Anna-Laura and Schneider-Rothhaar, Javen Lennard
                      and Steinbach, Joachim Peter and Hau, Peter and Kowalski,
                      Thomas and Seidel, Clemens and Krex, Dietmar and Grauer,
                      Oliver and Goldbrunner, Roland and Zeiner, Pia Susan and
                      Tabatabai, Ghazaleh and Galldiks, Norbert and Stummer,
                      Walter and Hattingen, Elke and Glas, Martin and Gkika, Eleni
                      and Vatter, Hartmut and Radbruch, Alexander and Herrlinger,
                      Ulrich and Weller, Johannes and Schaub, Christina},
      title        = {{Q}uantitative assessment of residual tumor is a strong and
                      independent predictor of survival in methylated glioblastoma
                      following radiochemotherapy with lomustine/temozolomide},
      journal      = {Neuro-Oncology},
      volume       = {27},
      number       = {2},
      issn         = {1522-8517},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {FZJ-2025-00782},
      pages        = {557-566},
      year         = {2025},
      note         = {The CeTeG/NOA-09 trial was funded by the German Ministry
                      for Education and Research.},
      abstract     = {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.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {5252 - Brain Dysfunction and Plasticity (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5252},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {39351820},
      UT           = {WOS:001374764100001},
      doi          = {10.1093/neuonc/noae205},
      url          = {https://juser.fz-juelich.de/record/1037611},
}