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MGMT methylation may benefit overall survival in patients with moderately vascularized glioblastomas.

Abstract：

OBJECTIVES:To assess the combined role of tumor vascularity, estimated from perfusion MRI, and MGMT methylation status on overall survival (OS) in patients with glioblastoma. METHODS:A multicentric international dataset including 96 patients from NCT03439332 clinical study were used to study the prognostic relationships between MGMT and perfusion markers. Relative cerebral blood volume (rCBV) in the most vascularized tumor regions was automatically obtained from preoperative MRIs using ONCOhabitats online analysis service. Cox survival regression models and stratification strategies were conducted to define a subpopulation that is particularly favored by MGMT methylation in terms of OS. RESULTS:rCBV distributions did not differ significantly (p > 0.05) in the methylated and the non-methylated subpopulations. In patients with moderately vascularized tumors (rCBV < 10.73), MGMT methylation was a positive predictive factor for OS (HR = 2.73, p = 0.003, AUC = 0.70). In patients with highly vascularized tumors (rCBV > 10.73), however, there was no significant effect of MGMT methylation (HR = 1.72, p = 0.10, AUC = 0.56). CONCLUSIONS:Our results indicate the existence of complementary prognostic information provided by MGMT methylation and rCBV. Perfusion markers could identify a subpopulation of patients who will benefit the most from MGMT methylation. Not considering this information may lead to bias in the interpretation of clinical studies. KEY POINTS:• MRI perfusion provides complementary prognostic information to MGMT methylation. • MGMT methylation improves prognosis in glioblastoma patients with moderate vascular profile. • Failure to consider these relations may lead to bias in the interpretation of clinical studies.

journal_name

Eur Radiol

journal_title

European radiology

authors

Fuster-Garcia E,Lorente Estellés D,Álvarez-Torres MDM,Juan-Albarracín J,Chelebian E,Rovira A,Acosta CA,Pineda J,Oleaga L,Mollá-Olmos E,Filice S,Due-Tønnessen P,Meling TR,Emblem KE,García-Gómez JM

doi

10.1007/s00330-020-07297-4

subject

Has Abstract

pub_date

2020-10-01 00:00:00

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-020-07297-4

pub_type

杂志文章

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