Correlation between EGF and VEGF expression levels and the efficacy of radiosurgery in recurrent glioma

To investigate the expression levels of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) in patients with recurrent glioma and to explore their correlation with patient prognosis following radiosurgery.

A retrospective analysis was conducted on 83 patients with recurrent glioma who received radiosurgery treatment (observation group). An additional 83 patients who underwent decompressive craniectomy for traumatic brain injury were included as the control group. EGF and VEGF concentrations in cerebrospinal fluid (CSF) were measured and compared between the two groups. In the observation group, EGF and VEGF levels were further analyzed according to various clinical parameters. After a 1-year follow-up, patients in the observation group were categorized into a survival group (n = 44) and a death group (n = 39) based on prognosis. Differences in clinical characteristics and EGF/VEGF expression between the two subgroups were compared, and prognostic factors were analyzed. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive value of EGF and VEGF for patient prognosis, and Kaplan-Meier survival analysis was conducted based on high and low expression levels of these biomarkers.

CSF levels of EGF and VEGF were significantly elevated in the observation group compared to the control group. Among patients with glioma, those with WHO grade III-IV tumors exhibited higher EGF levels than those with grade II tumors. EGF and VEGF levels were also significantly higher in patients with a Karnofsky Performance Status (KPS) score <80 and in the death group compared to those with a KPS ≥80 and the survival group (P<0.05). Multivariate logistic regression analysis identified VEGF ≥300.94 ng/L, EGF ≥102.50 ng/L, and WHO grade III-IV glioma as independent predictors of poor prognosis following radiosurgery. ROC analysis showed optimal prognostic cutoff values of 301.48 ng/L for VEGF (AUC = 0.747) and 100.98 ng/L for EGF (AUC = 0.793). Combined analysis of EGF and VEGF yielded an AUC of 0.803 for prognosis prediction. Kaplan-Meier survival curves showed that patients with low VEGF expression had significantly longer overall survival than those with high VEGF expression (P<0.05).

Elevated CSF levels of EGF and VEGF are closely associated with tumor severity and poor prognosis in recurrent glioma. These biomarkers may serve as valuable indicators for predicting radiosurgical outcomes and guiding clinical decision-making.