Incidence and outcome of pseudoprogression after radiation therapy in glioblastoma patients: A cohort study.

Autor:	Blakstad H; Department of Oncology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Mendoza Mireles EE; Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.; Vilhelm Magnus Laboratory, Institute for Surgical Research, Oslo University Hospital, Oslo, Norway., Heggebø LC; Department of Oncology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Magelssen H; Department of Oncology, Oslo University Hospital, Oslo, Norway., Sprauten M; Department of Oncology, Oslo University Hospital, Oslo, Norway., Johannesen TB; Department of Oncology, Oslo University Hospital, Oslo, Norway.; Cancer Registry of Norway, Oslo, Norway., Vik-Mo EO; Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.; Vilhelm Magnus Laboratory, Institute for Surgical Research, Oslo University Hospital, Oslo, Norway., Leske H; Department of Pathology, Oslo University Hospital, Oslo.; University of Oslo, Oslo, Norway., Niehusmann P; Department of Pathology, Oslo University Hospital, Oslo.; Division of Cancer Medicine, Oslo University Hospital, Oslo., Skogen K; Department of Radiology, Oslo University Hospital, Oslo, Norway., Helseth E; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Neurosurgery, Oslo University Hospital, Oslo, Norway., Emblem KE; Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Brandal P; Department of Oncology, Oslo University Hospital, Oslo, Norway.; Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.
Jazyk:	angličtina
Zdroj:	Neuro-oncology practice [Neurooncol Pract] 2023 Oct 03; Vol. 11 (1), pp. 36-45. Date of Electronic Publication: 2023 Oct 03 (Print Publication: 2024).
DOI:	10.1093/nop/npad063
Abstrakt:	Background: Differentiating post-radiation MRI changes from progressive disease (PD) in glioblastoma (GBM) patients represents a major challenge. The clinical problem is two-sided; avoid termination of effective therapy in case of pseudoprogression (PsP) and continuation of ineffective therapy in case of PD. We retrospectively assessed the incidence, management, and prognostic impact of PsP and analyzed factors associated with PsP in a GBM patient cohort. Methods: Consecutive GBM patients diagnosed in the South-Eastern Norway Health Region from 2015 to 2018 who had received RT and follow-up MRI were included. Tumor, patient, and treatment characteristics were analyzed in relationship to re-evaluated MRI examinations at 3 and 6 months post-radiation using Response Assessment in Neuro-Oncology criteria. Results: A total of 284 patients were included in the study. PsP incidence 3 and 6 months post-radiation was 19.4% and 7.0%, respectively. In adjusted analyses, methylated O 6 - methylguanine-DNA methyltransferase ( MGMT ) promoter and the absence of neurological deterioration were associated with PsP at both 3 ( p < .001 and p = .029, respectively) and 6 months ( p = .045 and p = .034, respectively) post-radiation. For patients retrospectively assessed as PD 3 months post-radiation, there was no survival benefit of treatment change ( p = .838). Conclusions: PsP incidence was similar to previous reports. In addition to the previously described correlation of methylated MGMT promoter with PsP, we also found that absence of neurological deterioration significantly correlated with PsP. Continuation of temozolomide courses did not seem to compromise survival for patients with PD at 3 months post-radiation; therefore, we recommend continuing adjuvant temozolomide courses in case of inconclusive MRI findings. Competing Interests: None declared. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology.)
Databáze:	MEDLINE
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