Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave, PO Box 648, Rochester, NY 14642-8648, USA.
Radiology. 2010 Aug;256(2):575-84. doi: 10.1148/radiol.10091440. Epub 2010 Jun 7.
To evaluate perfusion parameter changes in patients with glioblastoma multiforme by comparing the perfusion magnetic resonance (MR) imaging measurements obtained before combined radiation and temozolomide therapy (RT-TMZ) with the follow-up MR imaging measurements obtained 1 month after completion of this treatment.
Institutional review board approval was obtained, and HIPAA guidelines were followed. The data of 36 patients (24 male [median age, 63 years]; 12 female [median age, 59 years]) with glioblastoma multiforme who were treated with RT-TMZ were retrospectively reviewed. The hypothesis was that a change in relative cerebral blood volume (rCBV) 1 month after RT-TMZ is predictive of overall survival. Linear regression analysis was performed to correlate changes in tumor size and perfusion parameters with overall survival. Receiver operating characteristic (ROC) curves were evaluated for 1-year survival. Overall survival was assessed with Kaplan-Meir survival curves and log-rank testing.
Percentage change in rCBV at 1 month after RT-TMZ correlated with overall survival. Increased rCBV after treatment was a strong predictor of poor survival (median survival, 235 days versus 529 days with decreased rCBV) (P < .008, log-rank test). The ROC curves for 1-year survival showed a greater area under the curve (0.806; 95% confidence interval [CI]: 0.698, 0.970) (P = .005) with rCBV than with tumor size (0.556; 95% CI: 0.342, 0.729) (P = .382). The overall survival for patients with increased tumor size, based on Macdonald criteria, was shorter than that for patients who showed no progression (stable or partial response), but the difference was not significant (median survival, 442 days versus 598 days) (P = .761, log-rank test).
Change in rCBV after RT-TMZ appears to correlate with overall survival.
通过比较接受放化疗联合替莫唑胺治疗（RT-TMZ）前后的灌注磁共振成像（MR）测量值，评估多形性胶质母细胞瘤患者的灌注参数变化。
本研究回顾性分析了 36 例接受 RT-TMZ 治疗的多形性胶质母细胞瘤患者（24 例男性[中位年龄，63 岁]；12 例女性[中位年龄，59 岁]）的资料。假设 RT-TMZ 治疗 1 个月后相对脑血容量（rCBV）的变化与总生存期相关。采用线性回归分析，将肿瘤大小和灌注参数的变化与总生存期进行相关性分析。采用受试者工作特征（ROC）曲线评估 1 年生存率。采用 Kaplan-Meier 生存曲线和对数秩检验评估总生存期。
RT-TMZ 治疗 1 个月后 rCBV 的变化百分比与总生存期相关。治疗后 rCBV 增加是生存不良的强烈预测因子（中位生存期，rCBV 降低者为 235 天，rCBV 增加者为 529 天）（P＜0.008，对数秩检验）。1 年生存率的 ROC 曲线显示 rCBV 的曲线下面积（0.806；95%置信区间：0.698，0.970）大于肿瘤大小（0.556；95%置信区间：0.342，0.729）（P=0.005）。根据 Macdonald 标准，肿瘤体积增大的患者的总体生存期短于无进展（稳定或部分缓解）的患者，但差异无统计学意义（中位生存期，442 天比 598 天）（P=0.761，对数秩检验）。
RT-TMZ 后 rCBV 的变化似乎与总生存期相关。
