{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:50:28Z","timestamp":1770814228299,"version":"3.50.1"},"reference-count":11,"publisher":"Media Sphere Publishing House","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Burdenko's Journal of Neurosurgery"],"published-print":{"date-parts":[[2026,2,11]]},"abstract":"<jats:p>Objective. To create a prognostic scale for overall survival in grade 4 astrocytomas based on molecular biological data. Material and methods. After morphological confirmation of WHO grade 4 astrocytoma (2021 WHO classification criteria), 175 patients were classified as GBM (grade 4) without IDH1 mutations; IDH1 mutation was detected in 25 patients (12.5%; G4 astrocytoma). Molecular biological analysis of IDH1 gene mutations and MGMT promoter methylation was performed in 194 (97%) patients. Results. To study concomitant significance of IDH1 mutation and MGMT promoter methylation in grade 4 gliomas, we created the IDH1\/MGMT index(0 \u2014 IDH1+\/MGMT+; 1 \u2014 IDH1\/MGMT (+\/\u2013); 2 \u2014 IDH1-\/MGMT-). This predictor was digitized in 194 patients who underwent molecular analysis. The most informative classification matrix according to overall survival was as follows: IDH1\/MGMT index (OR=1.712; p=0.0004), REP (OR=1.971; p=0.0001), functional status before microsurgery at the lowest possible level (OR=1.797; p=0.001). Simple summation of numerical indicators for factors 1\u20143 in each patient allowed us to identify 5 prognostic classes: class 1 (0\u20141 points), class 2 (2 points), class 3 (3 points), class 4 (4 points), class 5 (5 points). Log-rank criterion for Kaplan-Meier survival curves revealed significant differences between classes (\u03c72=55.780; p&lt;0.001). The median survival rates were 71.5, 42.3, 23.6, 17.4 and 8.1 months, respectively. Significant differences in survival were noted between almost all neighboring classes: classes 1\u20142 (\u03c72=3.21; p=0.073), classes 2\u20143 (\u03c72=5.77; p=0.016), classes 3\u20144 (\u03c72=6.03; p=0.014), classes 4\u20145 (\u03c72=11.97; p=0.0005). In \u201cclasses 1\u20143\u201d in prognostic scale, median overall survival was 44.98 months (n=53; 95% CI: 20.5\u201469.4) for 3 Gy fractionation regimen and only 23.23 months (n=78; 95% CI: 17.3\u201429.1; \u03c72=9.28; p=0.002) for 2 Gy regimen. There were other results for classes 4\u20145. Median overall survival for 3 and 2 Gy fractionation regimens was low: 17.41 (n=28; 95% Cl: 13.8\u201421.0) and 15.83 months (n=41; 95% Cl: 11.7\u201420.0; \u20132=0.59; p=0.442), respectively. Conclusion. The new prognostic scale for overall survival, based on molecular data, allows not only to predict further course of disease, but also to recommend irradiation 3 Gy for patients in classes 1\u20143 as an alternative to radiotherapy.<\/jats:p>","DOI":"10.17116\/neiro20269001165","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T08:12:07Z","timestamp":1770797527000},"page":"65","source":"Crossref","is-referenced-by-count":0,"title":["Overall survival prediction scale for patients with grade 4 brain astrocytoma"],"prefix":"10.17116","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9808-2328","authenticated-orcid":false,"given":"P.V.","family":"Datsenko","sequence":"first","affiliation":[{"name":"National Research Medical Center of Radiology","place":["Moscow, Russia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5778-1504","authenticated-orcid":false,"given":"A.S.","family":"Chuguev","sequence":"additional","affiliation":[{"name":"National Research Medical Center of Radiology","place":["Moscow, Russia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3443-7633","authenticated-orcid":false,"given":"V.A.","family":"Gerasimov","sequence":"additional","affiliation":[{"name":"National Research Medical Center of Radiology","place":["Moscow, Russia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8784-8415","authenticated-orcid":false,"given":"A.D.","family":"Kaprin","sequence":"additional","affiliation":[{"name":"National Research Medical Center of Radiology","place":["Moscow, Russia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6743","reference":[{"key":"key-10.17116\/neiro20269001165-1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab106"},{"key":"key-10.17116\/neiro20269001165-2","doi-asserted-by":"publisher","DOI":"10.18027\/2224-5057-2023-13-3s2-1-120-147"},{"key":"key-10.17116\/neiro20269001165-3","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14246180"},{"key":"key-10.17116\/neiro20269001165-4","doi-asserted-by":"publisher","DOI":"10.17116\/neiro20238703140"},{"key":"key-10.17116\/neiro20269001165-5","doi-asserted-by":"publisher","DOI":"10.17116\/neiro20248805123"},{"key":"key-10.17116\/neiro20269001165-6","doi-asserted-by":"publisher","DOI":"10.17116\/onkolog20241305112"},{"key":"key-10.17116\/neiro20269001165-7","doi-asserted-by":"publisher","DOI":"10.17116\/onkolog20241305112"},{"key":"key-10.17116\/neiro20269001165-8","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.9.704"},{"key":"key-10.17116\/neiro20269001165-9","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.5963"},{"key":"key-10.17116\/neiro20269001165-10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.06.012"},{"key":"key-10.17116\/neiro20269001165-11","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.597587"}],"container-title":["Burdenko's Journal of Neurosurgery"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T08:12:15Z","timestamp":1770797535000},"score":1,"resource":{"primary":{"URL":"https:\/\/mediasphera.ru\/issues\/zhurnal-voprosy-nejrokhirurgii-imeni-n-n-burdenko\/2026\/1\/1004288172026011065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2,11]]}},"alternative-id":["10.17116\/neiro20269001165"],"URL":"https:\/\/doi.org\/10.17116\/neiro20269001165","relation":{},"ISSN":["0042-8817"],"issn-type":[{"value":"0042-8817","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,11]]}}}