Plasma IGFBP-2 levels after postoperative combined radiotherapy and chemotherapy predict prognosis in elderly glioblastoma patients

PLoS One. 2014 Apr 1;9(4):e93791. doi: 10.1371/journal.pone.0093791. eCollection 2014.

Abstract

It has been found that preoperative plasma IGFBP-2 levels correlate with prognosis in glioma patients. The prognostic value of plasma IGFBP-2 after postoperative combined radiotherapy and chemotherapy in glioma patients is unknown. Plasma IGFBP-2 levels in 83 glioblastoma patients after postoperative radiotherapy plus chemotherapy were analyzed using an IGFBP-2 ELISA kit. We found that after standard therapy plasma IGFBP-2 levels significantly correlated with the patient's age (R = 0.738, P<0.001) and Karnofsky performance status (KPS, R = -0.633, P<0.05). Cox proportional hazards models were used to calculate hazard ratios (HRs) of death according to plasma IGFBP-2 levels adjusted for patient clinical characteristics. Plasma IGFBP-2 levels significantly correlated with overall survival in glioblastoma patients (multivariate HR = 1.035; 95% CI, 1.024-1.047; P<0.001). The effect of plasma IGFBP-2 levels on survival seemed to differ according to patients' age. Among patients older than 60, high plasma IGFBP-2 levels were associated with a significant increase in overall mortality (HR = 1.097; 95% CI, 1.055-1.140; P<0.001). In contrast, plasma IGFBP-2 levels conferred no significant effect on mortality among patients younger than 60. Elevated plasma IGFBP-2 levels after combined postoperative radiotherapy and chemotherapy in elderly glioblastoma patients correlate with poor KPS score and predicts poor prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • Combined Modality Therapy
  • Female
  • Glioblastoma / blood*
  • Glioblastoma / drug therapy*
  • Glioblastoma / pathology
  • Glioblastoma / radiotherapy*
  • Glioblastoma / surgery
  • Humans
  • Insulin-Like Growth Factor Binding Protein 2 / blood*
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Postoperative Period
  • Prognosis
  • Proportional Hazards Models
  • Survival Analysis

Substances

  • Biomarkers, Tumor
  • IGFBP2 protein, human
  • Insulin-Like Growth Factor Binding Protein 2

Grants and funding

This work was supported by grants from the National High Technology Research and Development Program of China (863) (No. 2012AA02A508), National Natural Science Foundation of China (No. 81172409) and Science and Technology Department of Liaoning Province (No. 2011225034). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.