| Autor: |
Wetzel, Ethan A, Farrell, Matthew J, Eldred, Blaine SC, Liu, Vicki, Saha, Ishan, Zapanta Rinonos, Serendipity, Prins, Terry, Li, Tie, Cao, Minsong, Hegde, John, Kaprealian, Tania, Khanlou, Negar, Liau, Linda M, Nghiemphu, Phioanh Leia, Cloughesy, Timothy Francis, Chong, Robert A, Ellingson, Benjamin M, Lai, Albert |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
Neuro-oncology advances, vol 5, iss 1 |
| Popis: |
BackgroundTumor surveillance of isocitrate dehydrogenase (IDH) mutant gliomas is accomplished via serial contrast MRI. When new contrast enhancement (CEnew) is detected during postsurgical surveillance, clinicians must assess whether CEnew indicates pseudoprogression (PsP) or tumor progression (TP). PsP has been better studied in IDH wild-type glioblastoma but has not been well characterized in IDH mutant gliomas. We conducted a retrospective study evaluating the incidence, predictors, natural history, and survival of PsP patients in a large cohort of IDH mutant glioma patients treated at a single institution.MethodsWe identified 587 IDH mutant glioma patients treated at UCLA. We directly inspected MRI images and radiology reports to identify CEnew and categorized CEnew into TP or PsP using MRI or histopathology.ResultsFifty-six percent of patients developed CEnew (326/587); of these, 92/326 patients (28% of CEnew; 16% of all) developed PsP and 179/326 (55%) developed TP. All PsP patients had prior radiation, chemotherapy, or chemoradiotherapy. PsP was associated with longer overall survival (OS) versus TP patients and similar OS versus no CEnew. PsP differs from TP based on earlier time of onset (median 5.8 vs 17.4 months from treatment, P < .0001) and MRI features that include punctate enhancement and enhancement location.ConclusionPsP patients represented 28% of CEnew patients and 16% of all patients; PsP patients demonstrated superior outcomes to TP patients, and equivalent survival to patients without CEnew. PsP persists for |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
