ESTRO 2025 - Abstract Book

S741

Clinical - CNS

ESTRO 2025

4081

Digital Poster THE PROGNOSTIC ROLE OF PRETREATMENT BLOOD CELLS RATIOS IN CHEMORADIOTHERAPY TREATED GLIOBLASTOMA Marco Lucarelli 1 , Giulia de Pasquale 1 , Rosario Bonelli 1 , Marianna Trignani 1 , Angelo Di Pilla 1 , Consuelo Rosa 1 , Andrea D'Aviero 1,2 , Marta Di Nicola 2 , Domenico Genovesi 1,2 1 Department of Radiation Oncology, "S.S. Annunziata" Hospital, Chieti, Italy. 2 Department of Medical, Oral and Biotechnological Sciences, “G. D’Annunzio” University of Chieti, Chieti, Italy Purpose/Objective: Glioblastoma multiforme (GBM) is the most prevalent malignant primary tumor of central nervous system, accounting to 14.5% of all central nervous system tumors and 48.6% of malignant brain ones. Even with standardized multimodal approach, the median overall survival for GBM patients is only 12–18 months post-diagnosis with differences that cannot be explained only by genetic features. Persistent inflammation has already been acknowledged as a catalyst for both the onset and the advancement of tumors. The systematic review and meta-analysis by Jarmuzek et al. 1 showed that these blood ratios can be useful and easy-to-perform inflammatory markers to assess the prognosis in GBM. Aim of our single center experience was to analyze the prognostic role of blood cells ratios in GBM, particularly neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI). Material/Methods: Data of patients with diagnosed GBM who underwent chemoradiotherapy (CRT) between January 2015 and January 2024 retrospective were retrospectively analysed. The Overall survival (OS) and the Progression free Survival (PFS) were defined as the intervals between the day of the diagnosis and the date of death/last visit for OS and the first recorded date of disease progression or death/last visit for PFS. Blood tests results were collected before starting CRT course.The NLR, the SII (Plateles×Neutrophils/Lymphocytes) and the SIRI (Monocytes×Neutrophils/Lymphocytes) were calculated and compared to reference values. Results: In our study, 67 patients were included. The median age was 60 ± 12 years old with a majority in male sex (40/67, 60%). The most frequent localization was in frontal area (23/67, 34%) and 16/67 were multiple GBM. Radical surgery was accomplished on 31/67 patients (46%). All patients underwent radiotherapy and concomitant chemotherapy with Temozolomide. Five patients showed a severe hematological toxicity and consequently treatment was interrupted. The median OS was 19 months and the median PFS, 16 months. Regarding blood cell count-derived inflammation indices, the Mantel-Cox curves showed a significant difference for OS in the comparisons of patients with inside the range vs over the range values of NLR, SII and SIRI with p-values=0.006, 0.08, 0.002 respectively (fig.1). According to PFS, no significant differences were found.