Yonsei Med J.  2013 Jan;54(1):101-107. 10.3349/ymj.2013.54.1.101.

Epidermal Growth Factor Receptor Is Related to Poor Survival in Glioblastomas: Single-Institution Experience

• Choi Y
• Song YJ
• Lee HS
• Hur WJ
• Sung KH
• Kim KU
• Choi SS
• Kim SJ
• Kim DC

• KMID: 1776924
• DOI: http://doi.org/10.3349/ymj.2013.54.1.101

Abstract

PURPOSE
There are conflicting results surrounding the prognostic significance of epidermal growth factor receptor (EGFR) status in glioblastoma (GBM) patients. Accordingly, we attempted to assess the influence of EGFR expression on the survival of GBM patients receiving postoperative radiotherapy.
MATERIALS AND METHODS
Thirty three GBM patients who had received surgery and postoperative radiotherapy at our institute, between March 1997 and February 2006, were included. The evaluation of EGFR expression with immunohistochemistry was available for 30 patients. Kaplan-Meier survival analysis and Cox regression were used for statistical analysis.
RESULTS
EGFR was expressed in 23 patients (76.7%), and not expressed in seven (23.3%). Survival in EGFR expressing GBM patients was significantly less than that in non-expressing patients (median survival: 12.5 versus 17.5 months, p=0.013). Patients who received more than 60 Gy showed improved survival over those who received up to 60 Gy (median survival: 17.0 versus 9.0 months, p=0.000). Negative EGFR expression and a higher radiation dose were significantly correlated with improved survival on multivariate analysis. Survival rates showed no differences according to age, sex, and surgical extent.
CONCLUSION
The expression of EGFR demonstrated a significantly deleterious effect on the survival of GBM patients. Therefore, approaches targeting EGFR should be considered in potential treatment methods for GBM patients, in addition to current management strategies.

Keyword

Epidermal growth factor receptor; glioblastoma; radiotherapy; survival

MeSH Terms

Adult
Aged
Brain Neoplasms/metabolism/*mortality/radiotherapy/surgery
Female
*Gene Expression Regulation, Neoplastic
Glioblastoma/metabolism/*mortality/radiotherapy/surgery
Humans
Immunohistochemistry
Male
Middle Aged
Proportional Hazards Models
Radiotherapy
Receptor, Epidermal Growth Factor/*metabolism
Treatment Outcome
Receptor, Epidermal Growth Factor

Figure

• 

  Fig. 1 Immunohistochemical staining of EGFR in glioblastoma tissue. The tumor cells of a glioblastoma showed large irregular nuclei and abundant cytoplasm on H&E staining (A), and were strongly positive for EGFR (B). Tumor cells of another patient showed negativity for EGFR (C) (×400). EGFR, epidermal growth factor receptor.

• 

  Fig. 2 EGFR expression in relation to survival in glioblastoma patients. (A) Median survival times of negative and positive EGFR expression were 17.5 and 12.5 months, respectively (p=0.013). Survival differences according to EGFR expression were sustained in patients stratified according to radiation doses of up to 60 Gy (p=0.020) (B) and more than 60 Gy (p=0.037) (C). EGFR, epidermal growth factor receptor.

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