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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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The rate of pseudoprogression in secondary glioblastomas

Meeting Abstract

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  • Tareq A. Juratli - Klinik und Poliklinik für Neurochirurgie Universitätsklinik Carl Gustav Carus Dresden an der Technischen Universität Dresden
  • Kay Engellandt - Abteilung für Neuroradiologie Universitätsklinik Carl Gustav Carus Dresden an der Technischen Universität Dresden
  • Tim Lautenschlaeger - Department of Radiation Oncology The Ohio State University Medical School, Columbus, Ohio, U.S.A.
  • Kathrin D. Geiger - Institut für Neuropathologie Universitätsklinik Carl Gustav Carus Dresden an der Technischen Universität Dresden
  • Rüdiger von Kummer - Abteilung für Neuroradiologie Universitätsklinik Carl Gustav Carus Dresden an der Technischen Universität Dresden
  • Jana Cerhova - Abteilung für Neuroradiologie Universitätsklinik Carl Gustav Carus Dresden an der Technischen Universität Dresden
  • Arnab Chakravarti - Department of Radiation Oncology The Ohio State University Medical School, Columbus, Ohio, U.S.A.
  • Dietmar Krex - Klinik und Poliklinik für Neurochirurgie Universitätsklinik Carl Gustav Carus Dresden an der Technischen Universität Dresden
  • Gabriele Schackert - Klinik und Poliklinik für Neurochirurgie Universitätsklinik Carl Gustav Carus Dresden an der Technischen Universität Dresden

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 172

doi: 10.3205/14dgnc566, urn:nbn:de:0183-14dgnc5664

Published: May 13, 2014

© 2014 Juratli et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Pseudoprogression (PP) during adjuvant treatment of glioblastoma (GBM) is frequent and a clinically as well as radiologically challenging problem. While there are several reports on the frequency of PP in GBM cohorts mainly including patients with primary GBM, there is not much data on the incidence of PP in patients with secondary glioblastomas (sGBM). Therefore, the goal of this study is to evaluate the frequency of PP in sGBM.

Method: We retrospectively evaluated the incidence of PP in adult patients with sGBM treated with radiochemotherapy (RCTx) using temozolomide (TMZ) and sought out to assess if there is an association between PP and MGMT promoter methylation status, IDH mutations status, or 1p/19q co-deletion. The definition of PP according to the Response Assessment in Neuro-Oncology Working Group was used.

Results: None of the evaluable 15 sGBM patients in our series demonstrated a PP. Of the nine sGBM patients who received concomitant RCTx with TMZ six patients had a methylated MGMT promoter and six patients had IDH mutations. There also was no PP identified in sGBM patients who received sequential RCTx, irrespective of MGMT or IDH status. The median time of follow-up was 3.4 years after the diagnosis of a sGBM and the median overall survival was 18.2 months (range 14.3–45.2 months). Three out of 15 patients had previously received radiation therapy for their low-grade glioma WHO °II (LGG), while none of them had received chemotherapy at that stage.

Conclusions: Based on this small series of sGBM patients treated with RCTx (concomitantly or sequentially) the frequency of PP appears to be very low in sGBM, even in those patients with methylated MGMT promoter or IDH mutations. Our results highlight the differences between pGBM and sGBM in particular as it relates to PP.