Table_1_A Prognostic Model for Glioblastoma Patients Treated With Standard Therapy Based on a Prospective Cohort of Consecutive Non-Selected Patients From a Single Institution.docx

BackgroundGlioblastoma patients administered standard therapies, comprising maximal surgical resection, radiation therapy with concomitant and adjuvant temozolomide, have a variable prognosis with a median overall survival of 15–16 months and a 2-year overall survival of 30%. The aim of this study was to develop a prognostic nomogram for overall survival for glioblastoma patients treated with standard therapy outside clinical trials.MethodsThe study included 680 consecutive, non-selected glioblastoma patients administered standard therapy as primary treatment between the years 2005 and 2016 at Rigshospitalet, Copenhagen, Denmark. The prognostic model was generated employing multivariate Cox regression analysis modeling overall survival.ResultsThe following poor prognostic factors were included in the final prognostic model for overall survival: Age (10-year increase: HR = 1.18, 95% CI: 1.08–1.28, p < 0.001), ECOG performance status (PS) 1 vs. 0 (HR = 1.30, 95% CI: 1.07–1.57, p = 0.007), PS 2 vs. 0 (HR = 2.99, 95% CI: 1.99–4.50, p < 0.001), corticosteroid use (HR = 1.42, 95% CI: 1.18–1.70, p < 0.001), multifocal disease (HR = 1.63, 95% CI: 1.25–2.13, p < 0.001), biopsy vs. resection (HR = 1.35, 95% CI: 1.04–1.72, p = 0.02), un-methylated promoter of the MGMT (O6-methylguanine-DNA methyltransferase) gene (HR = 1.71, 95% CI: 1.42–2.04, p < 0.001). The model was validated internally and had a concordance index of 0.65.ConclusionA nomogram for overall survival was established. This model can be used for risk stratification and treatment planning, as well as improve enrollment criteria for clinical trials.

背景：接受标准治疗的胶质母细胞瘤患者，包括最大范围手术切除、同步放化疗及辅助性替莫唑胺治疗，其预后各异，中位总生存期为15至16个月，2年总生存率为30%。本研究旨在为接受标准治疗且非临床试验中的胶质母细胞瘤患者开发一种总生存期预后列线图。方法：研究纳入了2005年至2016年在丹麦哥本哈根的Rigshospitalet医院接受标准治疗的680例连续、非选择性的胶质母细胞瘤患者。预后模型采用多变量Cox回归分析构建总生存期模型。结果：最终的总生存期预后模型中包含以下不良预后因素：年龄（每增加10岁：HR = 1.18，95% CI：1.08–1.28，p < 0.001）、ECOG功能状态（PS）1与0相比（HR = 1.30，95% CI：1.07–1.57，p = 0.007）、PS 2与0相比（HR = 2.99，95% CI：1.99–4.50，p < 0.001）、皮质类固醇的使用（HR = 1.42，95% CI：1.18–1.70，p < 0.001）、多灶性病变（HR = 1.63，95% CI：1.25–2.13，p < 0.001）、活检与切除相比（HR = 1.35，95% CI：1.04–1.72，p = 0.02）、MGMT（O6-甲基鸟嘌呤-DNA甲基转移酶）基因启动子未甲基化（HR = 1.71，95% CI：1.42–2.04，p < 0.001）。模型内部验证后，一致性指数为0.65。结论：建立了总生存期列线图。此模型可用于风险分层、治疗计划制定，并有助于提高临床试验的入组标准。