Longitudinal analysis of systemic inflammatory biomarkers in glioblastoma patients: an exploratory single‑center analysis.

PURPOSE: To explore the systemic inflammatory biomarker changes throughout the entire treatment period from the perspective of the extent of surgical resection and their possible role in predicting survival in glioblastoma.

METHODS

A retrospective analysis was performed on 41 glioblastoma patients who underwent either gross total resection (GTR, n = 14) or subtotal resection (STR, n = 27), followed by adjuvant radiotherapy (60 Gy) with concurrent and adjuvant temozolomide. Inflammatory biomarkers, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), systemic inflammatory index (SII), and systemic inflammation response index (SIRI), were calculated from routine blood tests. These biomarkers were measured at specific times: preoperatively, before radiotherapy, after chemoradiotherapy, at the sixth cycle of temozolomide, and at radiological and/or clinical progression. Survival outcomes were analyzed using the Kaplan-Meier method.

RESULTS

Median follow-up was 21 months. Patients with GTR had significantly better 2-year progression-free survival (42.9% vs. 18.5%, p = 0.033) and overall survival (50% vs. 33.3%, p = 0.045) compared to those with STR. Inflammatory biomarker levels remained higher in the STR group both after RT and following the sixth cycle of temozolomide than in the GTR group. Changes in biomarker levels were not affected by the interval between surgery and radiotherapy, Ki-67 status, the number of chemotherapy cycles, age, or gender.

CONCLUSION

Long-term patterns of systemic inflammatory biomarkers may reflect a higher inflammatory burden and a poorer prognosis in patients with glioblastoma. The predictive role of these biomarkers should be evaluated in prospectively collected, molecularly characterized cohorts.