ESTRO 2024 - Abstract Book

S781

Clinical - CNS

ESTRO 2024

Patients aged 65 years or older from four institutions with newly diagnosed IDH-wildtype glioblastoma who received radiotherapy (RT) with concurrent temozolomide between 2006 and 2021 were included. Patient factors including age, Karnofsky performance status (KPS), temporal muscle thickness, molecular factors (MGMT promoter methylation, EGFR amplification, TERT promoter mutation, TP53 mutation status), treatment factors including extent of resection and RT dose, and pretreatment laboratory parameters including serum De Ritis ratio, glucose level, neutrophil-to-lymphocyte ratio, platelet count, systemic inflammatory response index, and systemic immune inflammation index were included in the analysis. Primary endpoint was overall survival (OS).

Results:

A total of 490 patients were included for analysis and the median follow-up period was 17.4 months (range, 3.3 – 149.9) for survivors. Median OS was significantly prolonged in patients with De Ritis ratio <1.2 (18.2 months vs. 15.3 months, p = 0.022) and in patients with glucose level <150 mg/dL (18.7 months vs. 16.5 months, p = 0.034) per univariate analysis. In multivariate analysis, KPS ≥70, MGMT promoter methylation, extent of resection greater than partial resection, RT dose of ≥72 Gy in biological effective dose (α/β = 10 Gy), and De Ritis ratio <1.2 were significant prognostic factors for improved OS. In the subgroup of patients with available TERT promoter, TP53, and EGFR status (n = 217), KPS, TERT status, TP53 status, MGMT status, surgical extent, and De Ritis ratio were prognostic for OS.

Conclusion:

Along with well-known prognostic factors, pre-RT serum biomarkers including De Ritis ratio and glucose level also had prognostic values in elderly glioblastoma patients treated with temozolomide-based chemoradiation.

Keywords: Glioblastoma, Chemoradiation, De Ritis ratio

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