Relative cerebral blood volume as response predictor in the treatment of recurrent glioblastoma with anti-angiogenic therapy.

Autor: Breda-Yepes M; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Rodríguez-Hernández LA; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Gómez-Figueroa E; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Mondragón-Soto MG; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Arellano-Flores G; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Hernández-Hernández A; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Rodríguez-Rubio HA; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Martínez P; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Reyes-Moreno I; The American British Cowdray (ABC) Medical Center, Mexico City, Mexico., Álvaro-Heredia JA; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Gutiérrez Aceves GA; Department of Neuro-Oncology, National Institute of Neurology and Neurosurgery, Mexico., Villanueva-Castro E; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Sangrador-Deitos MV; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Alonso-Vanegas M; Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico., Guerrero-Juárez V; Emergency Department, National Institute of Neurology and Neurosurgery, Mexico., González-Aguilar A; The American British Cowdray (ABC) Medical Center, Mexico City, Mexico; Department of Neuro-Oncology, National Institute of Neurology and Neurosurgery, Mexico; Emergency Department, National Institute of Neurology and Neurosurgery, Mexico. Electronic address: synapseinstitute.initiative@gmail.com.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2023 Oct; Vol. 233, pp. 107904. Date of Electronic Publication: 2023 Jul 17.
DOI: 10.1016/j.clineuro.2023.107904
Abstrakt: Background: Glioblastoma is one of the most common brain tumors in adult populations, usually carrying a poor prognosis. While several studies have researched the impact of anti-angiogenic therapies, especially anti-VEFG treatments in glioblastoma, few have attempted to assess its progress using imaging studies.
Purpose: We attempted to analyze whether relative cerebral blood volume (rCBV) from dynamic susceptibility-weighted contrast-enhanced MRI (DSC-MRI) could predict response in patients with glioblastoma undergoing Bevacizumab (BVZ) treatment.
Methods: We performed a retrospective study evaluating patients with recurrent glioblastoma receiving anti-angiogenic therapy with BVZ between 2012 and 2017 in our institution. Patients were scheduled for routine MRIs at baseline and first-month follow-up visits. Studies were processed for DSC-MRI, cT1, and FLAIR images, from which relative cerebral blood volume measurements were obtained. We assessed patient response using the Response Assessment in Neuro-Oncology (RANO) working group criteria and overall survival.
Results: 40 patients were included in the study and were classified as Bevacizumab responders and non-responders. The average rCBV before treatment was 4.5 for both groups, and average rCBV was 2.5 for responders and 5.4 for non-responders. ROC curve set a cutoff point of 3.7 for rCBV predictive of response to BVZ. Cox Multivariate analysis only showed rCBV as a predictive factor of OS.
Conclusion: A statistically significant difference was found in rCBV between patients who responded and those who did not respond to BVZ treatment. rCBV may be a low-cost and effective marker to assess response to Bevacizumab treatment in GBM.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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