There are undoubtedly some disadvantages that we have to mention. As it has been pointed out in our previous review, they the lack of homogeneity inside the MRI scans, as well because the approach of digitization, might induce numerous variations in tumor delineation and also the subsequently determined volumes. Additionally, because the MRI was not performed during the optional time window of your to start with 48 h right after surgical procedure, visualization of your enhancing lesion was in all probability affected by postoperative improvements. More more than, our analysis was based on the tiny sample size, which may well invoke the typical statistical uncertainties. Within this examine, we didn't observe any association of MGMT linked parameters with patient outcome. It ought to be observed, on the other hand, the MLPA technique made use of to find out MGMT promoter methylation yielded evaluable ends in only half the samples obtainable for this investigation.
the strategy will work on paraffin tissue extracts but it necessitates comparatively preserved DNA, which we only could acquire inside a restricted quantity of cases, as evaluated by a multiplex control DNA PCR assay. In comparison to the commonly applied MSP PCR, MLPA has the advantage of supplying details within the methyla tion status of many websites during the MGMT regulatory area within a semi quantitative manner. The degree of this epigenetic adjust appears to be of predictive value, considering that tumors with incomplete MGMT promoter methylation are reported to fail on temozolomide, when these with full methylation show a substantial trend to react to this treatment method.
The rate of tumors with full methylation in our series was comparable to this report, but statistics could not be performed since the absolute number of situations was minimal. These final results, also since the lack of concordance amid MGMT promoter methylation status, mRNA and pro tein expression success, once yet again reflect the issues encountered when assessing MGMT status on regimen histologic materials, as by now reported in prior com parative research. Conclusions Our research showed the volume of residual net enhancing tumor before radiochemotherapy signifi cantly has an effect on survival in glioblastoma patients, although appropriate literature information are inconsistent. Also, the volume of preoperative necrosis appears to be of prognostic significance to the PFS. Another preopera tive volumetric parameters studied didn't considerably have an effect on either OS or PFS. It really is apparent that volumetry can nevertheless perform a substantial position in defining patients who run a higher danger if taken care of with traditional treatment. For these patients, different therapies should really be sought and better stra tification for long term scientific studies may be achieved. A substantial expression rate of MGMT protein in glioblastomas might be relevant to a a lot more indolent disorder phenotype.