Ellingson Benjamin M, Wen Patrick Y, van den Bent Martin J, Cloughesy Timothy F
Department of Radiological Sciences (B.M.E.), Department of Biomedical Physics, David Geffen School of Medicine at UCLA (B.M.E.); Department of Bioengineering, Henry Samueli School of Engineering and Applied Science at UCLA (B.M.E.); Brain Research Institute, David Geffen School of Medicine at UCLA (B.M.E., T.F.C.); UCLA Neuro-Oncology Program, David Geffen School of Medicine at UCLA, Los Angeles, California (B.M.E., T.F.C.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts (P.Y.W.); Department of Neuro-Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands (M.J.v.d.B.); Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California (T.F.C.).
Neuro Oncol. 2014 Oct;16 Suppl 7(Suppl 7):vii2-11. doi: 10.1093/neuonc/nou224.
Over the past 20 years, very few agents have been approved for the treatment of brain tumors. Recent studies have highlighted some of the challenges in assessing activity in novel agents for the treatment of brain tumors. This paper reviews some of the key challenges related to assessment of tumor response to therapy in adult high-grade gliomas and discusses the strengths and limitations of imaging-based endpoints. Although overall survival is considered the "gold standard" endpoint in the field of oncology, progression-free survival and response rate are endpoints that hold great value in neuro-oncology. Particular focus is given to advancements made since the January 2006 Brain Tumor Endpoints Workshop, including the development of Response Assessment in Neuro-Oncology criteria, the value of T2/fluid-attenuated inversion recovery, use of objective response rates and progression-free survival in clinical trials, and the evaluation of pseudoprogression, pseudoresponse, and inflammatory response in radiographic images.
在过去20年里，获批用于治疗脑肿瘤的药物极少。近期研究凸显了评估新型脑肿瘤治疗药物活性时面临的一些挑战。本文回顾了与评估成人高级别胶质瘤治疗后肿瘤反应相关的一些关键挑战，并讨论了基于成像的终点指标的优势与局限性。尽管总生存期被视为肿瘤学领域的“金标准”终点指标，但无进展生存期和缓解率在神经肿瘤学中也是具有重要价值的终点指标。本文特别关注自2006年1月脑肿瘤终点指标研讨会以来取得的进展，包括神经肿瘤学疗效评估标准的制定、T2加权/液体衰减反转恢复序列的价值、临床试验中客观缓解率和无进展生存期的应用，以及影像学图像中假性进展、假性缓解和炎症反应的评估。
