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De Ritis ratio in elderly glioblastoma patients treated with chemoradiation: A comprehensive analysis of serum biomarkers

Authors
 Jina Kim  ;  Hye In Lee  ;  In Ah Kim  ;  Joo Ho Lee  ;  Jaeho Cho  ;  Chan Woo Wee  ;  Hong In Yoon 
Citation
 NEURO-ONCOLOGY ADVANCES, Vol.6(1) : vdad173, 2024-01 
Journal Title
NEURO-ONCOLOGY ADVANCES
Issue Date
2024-01
Keywords
De Ritis ratio ; chemoradiation ; elderly ; glioblastoma ; glucose
Abstract
Background. We aimed to comprehensively investigate the prognostic value of pretreatment laboratory parameters in elderly patients with glioblastoma treated with temozolomide (TMZ)-based chemoradiation. Methods. Patients aged ≥ 65 years from 4 institutions with newly diagnosed IDH-wild-type glioblastoma who received radiotherapy (RT) with concurrent TMZ between 2006 and 2021 were included. Patient factors (age, Karnofsky performance status (KPS), temporalis muscle thickness), molecular factors (MGMT promoter methylation, EGFR amplification, TERT promoter mutation, and TP53 mutation status), treatment factors (extent of resection, and RT dose), and pretreatment laboratory parameters (serum De Ritis ratio, glucose level, neutrophil-to-lymphocyte ratio, platelet count, and systemic immune-inflammation index) were included in the analysis.The primary endpoint was overall survival (OS). Results. In total, 490 patients were included in the analysis.The median follow-up period was 12.3 months (range, 1.6–149.9 months). Median OS was significantly prolonged in patients with De Ritis ratio < 1.2 (18.2 vs 15.3 months, P = .022) and in patients with glucose level < 150 mg/dL (18.7 vs 16.5 months, P = .034) per univariate analysis. In multivariate analysis, KPS ≥ 70, MGMT promoter methylation, extent of resection greater than partial resection, De Ritis ratio < 1.2, and glucose level < 150 mg/dL were significant prognostic factors for improved OS. Conclusions. Along with well-known prognostic factors, pre-RT serum biomarkers, including the De Ritis ratio and glucose level, also had prognostic value in elderly patients with glioblastoma treated with TMZ-based chemoradiation. © The Author(s) 2023. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
Files in This Item:
T202402470.pdf Download
DOI
10.1093/noajnl/vdad173
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Wee, Chan Woo(위찬우)
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/199155
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