Factors involved in maintaining Karnofsky Performance Status (≥ 50%) in glioblastoma, IDH-wildtype patients treated with temozolomide and radiotherapy

Sci Rep. 2025 Jan 11;15(1):1750. doi: 10.1038/s41598-025-85339-x.

Abstract

Karnofsky Performance Status (KPS) is a widely used scale to assess performance status. KPS ≥ 50% implies that patients can live at home. Therefore, maintaining KPS ≥ 50% is important to improve the quality of life of patients with glioblastoma, whose median survival is less than 2 years. This study aimed to identify the factors associated with survival time with maintenance of KPS ≥ 50% (survival with KPS ≥ 50%) in patients with glioblastoma, IDH-wildtype. Ninety-eight patients with glioblastomas, IDH-wildtype, who were treated with concomitant radiotherapy (RT) and temozolomide (TMZ) followed by maintenance TMZ therapy, and whose KPS at the start of RT was ≥ 50%, were included. The median survival with KPS ≥ 50% was 13.3 months. In univariate analysis, preoperative KPS (≥ 80%), KPS at the start of RT (≥ 80%), residual tumor size (< 2 cm3), methylated MGMT promotor, and implantation of BCNU wafer were associated with survival with KPS ≥ 50%. In multivariate analysis, KPS at the start of RT (≥ 80%), methylated MGMT promotor, and residual tumor size (< 2 cm3) were significantly associated with increased survival with KPS ≥ 50%. A strategy of maximum possible tumor resection without compromising KPS is desirable to prolong the survival time with KPS ≥ 50%.

Keywords: Glioblastoma; Karnofsky Performance Status; MGMT; Radiotherapy; Temozolomide; Tumor size.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Brain Neoplasms* / drug therapy
  • Brain Neoplasms* / mortality
  • Brain Neoplasms* / pathology
  • Brain Neoplasms* / radiotherapy
  • Brain Neoplasms* / therapy
  • Chemoradiotherapy / methods
  • Female
  • Glioblastoma* / drug therapy
  • Glioblastoma* / mortality
  • Glioblastoma* / radiotherapy
  • Glioblastoma* / therapy
  • Humans
  • Isocitrate Dehydrogenase* / genetics
  • Karnofsky Performance Status*
  • Male
  • Middle Aged
  • Temozolomide* / therapeutic use

Substances

  • Temozolomide
  • Isocitrate Dehydrogenase
  • Antineoplastic Agents, Alkylating