Enhanced antitumor effects of radiotherapy combined local nimustine delivery rendezvousing with oral temozolomide chemotherapy in glioblastoma patients

Yang, Dong-Yi; Bu, Xingyao; Zhou, Zhi-Long; Yan, Zheng‐Guang; Ma, Chunxiao; Qu, Mingqi; Yuewu, Zhao; Kong, Lingfei; Wang, Yaowei; Luo, Jing

doi:10.4103/jcrt.jcrt_844_17

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…The method of assessing MGMT promoter methylation in these studies included real-time PCR using the ratio of MGMT to the βactin reference gene (ACTB) greater than 2 in 5 studies, 15 , 17 , 18 , 34 , 35 the methylated MGMT /COL2A1 ratio greater than 0 in one study, 20 nested PCR in one study, 37 pyrosequencing in one study, 19 and not specified in 4 trials. 22 , 23 , 27 , 36 …”

Section: Resultsmentioning

confidence: 99%

“…For this analysis, ACNU and Lomustine were grouped together (alkylating nitrosourea). 15 , 23 Two Bevacizumab studies were grouped together (Bevacizumab). 34 , 36 Nimotuzumab and Rindopepimut were combined (anti-EGFR); this is shown in Supplementary Figure 6B .…”

Section: Resultsmentioning

confidence: 99%

“…Response Assessment in Neuro-Oncology (RANO) criteria were used to define PFS in 3 studies, 15 , 22 , 37 Macdonald criteria were used to define PFS in 5 studies, 17 , 34 , 35 , 38 and PFS definition did not use either RANO or Macdonald criteria in one study. 23 …”

Section: Resultsmentioning

confidence: 99%

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Lessons learned from contemporary glioblastoma randomized clinical trials through systematic review and network meta-analysis: part 1 newly diagnosed disease

Taslimi

Zadeh

2021

Neuro-Oncology Advances

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Background Glioblastoma (GB) is the most common malignant brain tumour with a dismal prognosis despite standard of care (SOC). Here we used a network meta-analysis on treatments from randomized control trials (RCT) to assess effect on Overall survival (OS) and progression free survival (PFS) beyond the SOC. Methods We included RCT’s which investigated the addition of a new treatment to the SOC in patients with newly diagnosed GB. Our primary outcome was OS, with secondary outcomes including PFS and adverse reactions. Hazard ratio and its 95% confidence interval (CI) regarding OS and PFS were extracted from each paper. We utilized a frequentist network meta-analysis. We planned a subgroup analysis based on MGMT status. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Results Twenty-one studies were included representing a total of 7403 patients with GB. There was significant heterogeneity among studies impacting important factors such as timing of randomization, and sample size. A confidence analysis on the network meta-analysis results revealed a score of Low or Very Low for all treatment comparisons, across subgroups. Allowing for the hetereogeneity within the study population, Alkylating-nitrosureas (Lomustine and ACNU) and Tumor treating field (TTF) improved both OS (HR=0.53, 95%CI 0.33-0.84 and HR=0.63 95%CI 0.42-0.94 respectively) and PFS (HR=0.88, 95%CI 0.77-1.00 and HR=0.63 95%CI 0.52-0.76 respectively). Conclusions Our analysis highlights the numerous studies performed on newly diagnosed GB, with no proven consensus treatment that is superior to the current SOC. Inter-trial heterogeneity raises the need for better standardization in neuro-oncology studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Lessons learned from contemporary glioblastoma randomized clinical trials through systematic review and network meta-analysis: part 1 newly diagnosed disease

Taslimi

Zadeh

2021

Neuro-Oncology Advances

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“…Adjuvant therapies, such as chemotherapy and radiation, have a significant impact on patient survival, progression-free survival, and overall survival [38][39][40][41], and should be included in the standard of care for GBM patients alongside surgical treatment modalities. With a focus on the SVZ and high-dose proton beam treatment, Matsuda et al…”

Section: Discussionmentioning

confidence: 99%

Role of extent of resection on the survival of glioblastoma multiforme

Chaulagain,

Smolanka,

Smolanka

et al. 2023

roneuro

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Background. Glioblastoma Multiforme (GBM) is the most prevalent form of brain cancer. The effect of Extent of Resection (EOR) on GBM survival is controversial. EOR degree, pre- and postoperative tumour volume estimation, and significance to residual tumour volume are still challenged. GBM has a 14-month Overall Survival (OS) rate. There is no evidence of a link between EOR and OS survival. We wish to determine whether GBM tumour removal increases survival. Methods. At the Regional Center for Neurosurgery and Neurology in Uzhhorod, Ukraine, we conducted a retrospective evaluation of 86 consecutive patients diagnosed with glioblastoma who underwent surgery between January 1, 2010, and December 31, 2020, and who are being followed until January 1, 2022. Patients were selected if they met the following criteria: they were at least 18 years old, they had a diagnosis of glioblastoma (primary, secondary, or recurrent), they were either IDH mutants or wild types, they had an MRI within 2 weeks before surgery, and they had another MRI within 72 hours after surgery. Before and after surgery, we did a volumetric analysis of gadolinium-enhanced T1 MRI scans of the tumour to figure out EOR. Partial resection (PR) is <70%, sub-total resection (STR) is 70-90%, near-total resection (NTR) is 91-99%, and gross total resection (GTR) is >99%. By comparing pre- and post-operative volumes with the EOR, the Kaplan-Meier survival curve and Cox's regression analysis determined the impact of the EOR on survival rates. Many researchers considered a p value of 0.05 or below to be significant. Results. A total of 86 patients were included in the analysis after being subjected to the criteria used to narrow the pool of potential participants. The average length of time people lived was 15 months. For PR patients, the median survival time was 3 months, for STR patients it was 10 months, and for NTR patients it was 16 months. Patients receiving GTR, on the other hand, had a considerably better outcome, with a median survival time of 36 months. This data demonstrate a direct correlation between EOR and survival rates. It was discovered that EOR improvement affected post-op survival. High EOR patients have a better prognosis for survival. Adjuvant therapy, pre- and post-operative KPS score, pre- and post-operative tumour volume, and gender also contributed significantly to enhanced survival. Conclusion. Patients with glioblastoma appear to benefit from a more aggressive treatment strategy that combines maximal safe resection with the use of salvage adjuvant therapy. There was a correlation between complete resection (gross total resection) of intracranial GBM and improved survival. Whenever feasible, complete surgical removal of the tumour is recommended.

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“…Apart from surgical treatment strategies, adjuvant therapies including chemotherapy and radiotherapy should be considered in the standard of care for GBM patients as they also influence patient survival, PFS, and OS [ 5 , 49 – 51 ]. Matsuda et al [ 25 ] reported a median OS of 36.9 months for patients who underwent GTR of newly diagnosed GBM, with a particular focus on the influence of the subventricular zone (SVZ), combined with high-dose proton beam therapy, compared with a median OS of 26.2 months for patients treated with conventional radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

What is the advance of extent of resection in glioblastoma surgical treatment—a systematic review

Wang

Liang

et al. 2019

Chin Neurosurg Jl

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Glioblastoma multiform (GBM) is the most common malignant brain tumor characterized by poor prognosis, increased invasiveness, and high relapse rates. The relative survival estimates are quite low in spite of the standard treatment for GBM in recent years. Now, it has been gradually accepted that the amount of tumor mass removed correlates with longer survival rates. Although new technique advances allowing intraoperative analysis of tumor and normal brain tissue and functional paradigms based on stimulation techniques to map eloquent areas have been used for GBM resection, visual identification of tumor margins still remains a challenge for neurosurgeons. This article attempts to review and summarize the evolution of surgical resection for glioblastomas.

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Enhanced antitumor effects of radiotherapy combined local nimustine delivery rendezvousing with oral temozolomide chemotherapy in glioblastoma patients

Abstract: Compared to standard therapy, the antitumor effects of rendezvous therapy were more effective in GBM patients without increasing the toxicities.

Cited by 9 publications

References 22 publications

Lessons learned from contemporary glioblastoma randomized clinical trials through systematic review and network meta-analysis: part 1 newly diagnosed disease

Lessons learned from contemporary glioblastoma randomized clinical trials through systematic review and network meta-analysis: part 1 newly diagnosed disease

Role of extent of resection on the survival of glioblastoma multiforme

What is the advance of extent of resection in glioblastoma surgical treatment—a systematic review

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