title: Impact of delays in initiating postoperative chemoradiation while determining the MGMT promoter-methylation statuses of patients with primary glioblastoma
creator: Adeberg, Sebastian
creator: Bostel, Tilman
creator: Harrabi, Semi
creator: Bernhardt, Denise
creator: Welzel, Thomas
creator: Wick, Wolfgang
creator: Debus, Jürgen
creator: Combs, Stephanie E.
subject: ddc-610
subject: 610 Medical sciences Medicine
description: Background: The benefits of new innovations in glioblastoma therapies should not be curtailed as a result of delays in commencement of radiation therapy, caused by clinical circumstances as well as diagnostic procedures. This study evaluates whether delays in chemo-radiotherapy after surgery, while determining O6-methylguanine-DNA-methyltransferase (MGMT) promoter status, affect the survival rates of patients with glioblastoma (GBM).   Methods: Our sample comprised 50 GBM patients in a retrospective analysis of three prospective studies that focused on combined radiotherapy and required MGMT promoter-status testing as inclusion criteria. Results were compared with a reference group of 127 favourable GBM cases (Karnofsky performance-status scale ≥ 70), in which the patients underwent standard postoperative chemo-radiotherapy with temozolomide. Survival time was calculated using the Kaplan-Meier method, and a multivariate analysis of the delays between surgical and radiotherapy procedures was performed using the Cox regression model.   Results: The study group’s median overall survival time was 16.2 months (with a range of 2 to 56 months), versus the reference group’s survival time of 18.2 months (with a range of 1 to 92 months) (p = 0.64). The delay between surgery and radiotherapy was increased by 8 days in the study patients (p < 0.001), with a median delay of 35 days (range: 18–49 days) corresponding to the typical 27-day delay (range: 5–98 days) for those in the reference group. Univariate and multivariate analyses did not show any negative association between survival time and delaying radiation therapy to determine MGMT-promoter status; commencement of radiation therapy sooner than 24 days after surgery was the threshold for significantly decreased overall survival (p = 0.01) and progression-free (p = 0.03) survival.   Conclusion: Delaying postoperative chemoradiation for GBM patients—carried out in order to determine MGMT-promoter status—did not have a negative impact on survival time. Indeed, the data of the present study shows that initiating radiation therapy sooner than 24 days after surgery has a negative impact on progression and survival.  
publisher: BioMed Central
date: 2015
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserverhttps://archiv.ub.uni-heidelberg.de/volltextserver/19461/1/12885_2015_Article_1545.pdf
identifier: DOI:
identifier: urn:nbn:de:bsz:16-heidok-194612
identifier:   Adeberg, Sebastian ; Bostel, Tilman ; Harrabi, Semi ; Bernhardt, Denise ; Welzel, Thomas ; Wick, Wolfgang ; Debus, Jürgen ; Combs, Stephanie E.  (2015) Impact of delays in initiating postoperative chemoradiation while determining the MGMT promoter-methylation statuses of patients with primary glioblastoma.  BMC Cancer, 15 (558).  pp. 1-7.  ISSN 1471-2407     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/19461/
rights: info:eu-repo/semantics/openAccess
rights: Please see front page of the work (Sorry, Dublin Core plugin does not recognise license id)
language: eng