Artikel
The rate of pseudoprogression in secondary glioblastomas
Suche in Medline nach
Autoren
Veröffentlicht: | 13. Mai 2014 |
---|
Gliederung
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.