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<p>The 2021 WHO glioma classification integrates molecular profiling, but outcome data for these patients are limited. We retrospectively analyzed 179 patients (median age 53) with WHO 2021-classified gliomas (grade 2: n = 45, grade 3: n = 51, grade 4: n = 83) treated with surgery and radio(chemo)therapy across four centers in Poland and France. Chemotherapy was administered to 74.9% of patients, with a median radiotherapy dose of 60 Gy (range 32.5–80 Gy). IDH1/2 mutations were identified in 55.3% and 1p/19q codeletion in 22.4%. Patients with IDH1/2 mutations had significantly longer progression-free survival (PFS, 7.7 vs. 1.0 years) and overall survival (OS, 8.2 vs. 2.5 years), both <i>p</i> &lt; 0.01. 1p/19q codeletion was associated with prolonged PFS (7.7 vs. 1.6 years, <i>p</i> &lt; 0.01). In grade 3 gliomas, chemotherapy improved PFS (6.8 vs. 3.6 years) and OS (6.9 vs. 3.9 years), both <i>p</i> &lt; 0.01. Leukopenia grade 0–2 correlated with better PFS (3.6 vs. 1.2 years, p = 0.02) and OS (7.2 vs. 3.2 years, <i>p</i> = 0.04). Absolute lymphocyte count ≤ 1 × 10<sup>3</sup>/mm<sup>3</sup> predicted worse OS (5.3 vs. 8.7 years, <i>p</i> = 0.0043). CTV &lt; 127 cm<sup>3</sup> predicted longer OS in grade 4 gliomas (3.2 vs. 1.7 years, <i>p</i> = 0.012). Our findings provide new real-world evidence on survival and prognostic factors in this population, for which contemporary RWE and OS/PFS data remain scarce.</p>

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Real-world survival and prognostic factors in WHO 2021 classified gliomas treated with chemo-radiotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月30日

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  • Mateusz Bilski,
  • Georges Noël,
  • Krzysztof Smółka,
  • Katarzyna Kuncewicz,
  • Wojciech Kuźnicki,
  • Loic Feuvret,
  • Katarzyna Korab,
  • Magdalena Peszyńska-Piorun,
  • Paweł Korona,
  • Izabela Baranowska,
  • Agata Suleja,
  • Clara Le Fevre,
  • Roland Schott,
  • Laura Somme,
  • Salma Chabli,
  • Emmanuel Mesny,
  • Federico Mastroleo,
  • Rupesh Kotecha,
  • Jakub Jurkiewicz,
  • Jacek Fijuth,
  • Barbara Alicja Jereczek-Fossa,
  • Kamil Krystkiewicz,
  • Maciej Harat,
  • Łukasz Kuncman

摘要

The 2021 WHO glioma classification integrates molecular profiling, but outcome data for these patients are limited. We retrospectively analyzed 179 patients (median age 53) with WHO 2021-classified gliomas (grade 2: n = 45, grade 3: n = 51, grade 4: n = 83) treated with surgery and radio(chemo)therapy across four centers in Poland and France. Chemotherapy was administered to 74.9% of patients, with a median radiotherapy dose of 60 Gy (range 32.5–80 Gy). IDH1/2 mutations were identified in 55.3% and 1p/19q codeletion in 22.4%. Patients with IDH1/2 mutations had significantly longer progression-free survival (PFS, 7.7 vs. 1.0 years) and overall survival (OS, 8.2 vs. 2.5 years), both p < 0.01. 1p/19q codeletion was associated with prolonged PFS (7.7 vs. 1.6 years, p < 0.01). In grade 3 gliomas, chemotherapy improved PFS (6.8 vs. 3.6 years) and OS (6.9 vs. 3.9 years), both p < 0.01. Leukopenia grade 0–2 correlated with better PFS (3.6 vs. 1.2 years, p = 0.02) and OS (7.2 vs. 3.2 years, p = 0.04). Absolute lymphocyte count ≤ 1 × 103/mm3 predicted worse OS (5.3 vs. 8.7 years, p = 0.0043). CTV < 127 cm3 predicted longer OS in grade 4 gliomas (3.2 vs. 1.7 years, p = 0.012). Our findings provide new real-world evidence on survival and prognostic factors in this population, for which contemporary RWE and OS/PFS data remain scarce.