Lack of Benefit of Extending Temozolomide Treatment in Patients with High Vascular Glioblastoma with Methylated <i>MGMT</i>
In this study, we evaluated the benefit on survival of the combination of methylation of O6-methylguanine-DNA methyltransferase (<i>MGMT</i>) promotor gene and moderate vascularity in glioblastoma using a retrospective dataset of 123 patients from a multicenter cohort. MRI processing and...
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| Autores principales: | , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
MDPI AG
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/e03182da8c724756bdbef0356b366f8e |
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| Sumario: | In this study, we evaluated the benefit on survival of the combination of methylation of O6-methylguanine-DNA methyltransferase (<i>MGMT</i>) promotor gene and moderate vascularity in glioblastoma using a retrospective dataset of 123 patients from a multicenter cohort. MRI processing and calculation of relative cerebral blood volume (rCBV), used to define moderate- and high-vascular groups, were performed with the automatic ONCOhabitats method. We assessed the previously proposed rCBV threshold (10.7) and the new calculated ones (9.1 and 9.8) to analyze the association with survival for different populations according to vascularity and <i>MGMT</i> methylation status. We found that patients included in the moderate-vascular group had longer survival when <i>MGMT</i> is methylated (significant median survival difference of 174 days, <i>p</i> = 0.0129*). However, we did not find significant differences depending on the <i>MGMT</i> methylation status for the high-vascular group (<i>p</i> = 0.9119). In addition, we investigated the combined correlation of <i>MGMT</i> methylation status and rCBV with the prognostic effect of the number of temozolomide cycles, and only significant results were found for the moderate-vascular group. In conclusion, there is a lack of benefit of extending temozolomide treatment for patients with high vascular glioblastomas, even presenting <i>MGMT</i> methylation. Preliminary results suggest that patients with moderate vascularity and methylated <i>MGMT glioblastomas</i> would benefit more from prolonged adjuvant chemotherapy. |
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