ムラガキ　ヨシヒロ   MURAGAKI Yoshihiro   村垣　善浩    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Permeability surface area product using perfusion CT is a valuable prognostic factor in glioblastomas treated with radiotherapy plus concomitant and adjuvant temozolomide
掲載誌名	正式名：World Neurosurg ISSNコード：18788769 (Electronic)18788750 (Linking)
巻・号・頁	97,pp.21-26
著者・共著者	SAITO Taiichi†, SUGIYAMA Kazuhiko, IKAWA Fusao, YAMASAKI Fumiyuki, ISHIFURO Minoru, TAKAYASU Takeshi, NOSAKA Ryo, MURAGAKI Yoshihiro, KAWAMATA Takakazu, KURISU Kaoru
発行年月	2017/01
概要	OBJECTIVE: The current standard treatment protocol for patients with newly diagnosed glioblastoma (GBM) includes surgery, radiotherapy, and concomitant and adjuvant temozolomide (TMZ). We hypothesized that the permeability surface area product (PS) from a perfusion CT (PCT) study is associated with sensitivity to TMZ. The aim of this study was to determine whether PS values were correlated with prognosis of GBM patients who received the standard treatment protocol. METHODS: This study included 36 patients with GBM that were newly diagnosed between October 2005 and September 2014 and who underwent preoperative PCT study and the standard treatment protocol. We measured the maximum value of relative cerebral blood volume (rCBVmax) and the maximum PS value (PSmax). We statistically examined the relationship between PSmax and prognosis using survival analysis including other clinicopathological factors (age, Karnofsky performance status (KPS), extent of resection, O6-methylguanine-DNA methyltransferase (MGMT) status, second-line use of bevacizumab, and rCBVmax). RESULTS: Log rank tests revealed that age, KPS, MGMT status, and PSmax were significantly correlated with overall survival. Multivariate analysis using the Cox regression modelshowed that PSmax was the most significant prognostic factor. Receiver operating characteristic curve analysis showed that PSmax had the highest accuracy in differentiating long-time survivors (LTSs) (surviving more than 2 years) from non-LTSs. At a cut-off point of 8.26 ml/100 g/min, sensitivity and specificity were 90% and 70%, respectively. CONCLUSIONS: PSmax from PCT study can help predict survival time in patients with GBM received the standard treatment protocol. Survival may be related to sensitivity to TMZ.
DOI	10.1016/j.wneu.2016.09.072
文献番号	27693246