Gzell Cecelia Elizabeth, Wheeler Helen R, McCloud Philip, Kastelan Marina, Back Michael
Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, 2065, Australia.
Northern Sydney Clinical School, Sydney University Medical School, Sydney, NSW, 2065, Australia.
J Neurooncol. 2016 May;128(1):67-74. doi: 10.1007/s11060-016-2074-4. Epub 2016 Feb 15.
To assess impact of volumetric changes in tumour volume post chemoradiotherapy in glioblastoma. Patients managed with chemoradiotherapy between 2008 and 2011 were included. Patients with incomplete MRI sets were excluded. Analyses were performed on post-operative MRI, and MRIs at 1 month (M+1), 3 months (M+3), 5 months (M+5), 7 months (M+7), and 12 months (M+12) post completion of RT. RANO definitions of response were used for all techniques. Modified RANO criteria and two volumetric analysis techniques were used. The two volumetric analysis techniques involved utility of the Eclipse treatment planning software to calculate the volume of delineated tissue: surgical cavity plus all surrounding enhancement (Volumetric) versus surrounding enhancement only (Rim). Retrospective analysis of 49 patients with median survival of 18.4 months. Using Volumetric analysis the difference in MS for patients who had a <5 % increase versus ≥5 % at M+3 was 23.1 versus 15.1 months (p = 0.006), and M+5 was 26.3 versus 15.1 months (p = 0.006). For patients who were classified as progressive disease using modified RANO criteria at M+1 and M+3 there was a difference in MS compared with those who were not (M+1: 13.1 vs. 19.4 months, p = 0.017, M+3: 13.2 vs. 20.1 months, p = 0.096). An increase in the volume of cavity and enhancement of ≥5 % at M+3 and M+5 post RT was associated with reduced survival, suggesting that increases in radiological abnormality of <25 % may predict survival.
评估胶质母细胞瘤放化疗后肿瘤体积变化的影响。纳入2008年至2011年间接受放化疗的患者。排除MRI数据集不完整的患者。对术后MRI以及放疗结束后1个月（M + 1）、3个月（M + 3）、5个月（M + 5）、7个月（M + 7）和12个月（M + 12）的MRI进行分析。所有技术均采用RANO反应定义。使用了改良的RANO标准和两种体积分析技术。两种体积分析技术涉及利用Eclipse治疗计划软件计算划定组织的体积：手术腔加所有周围强化（总体积）与仅周围强化（边缘）。对49例中位生存期为18.4个月的患者进行回顾性分析。使用总体积分析，M + 3时体积增加<5%与≥5%的患者的中位生存期差异为23.1个月对15.1个月（p = 0.006），M + 5时为26.3个月对15.1个月（p = 0.006）。对于在M + 1和M + 3时根据改良RANO标准被分类为疾病进展的患者，与未被分类为疾病进展的患者相比，中位生存期存在差异（M + 1：13.1对19.4个月，p = 0.017，M + 3：13.2对20.1个月，p = 0.096）。放疗后M + 3和M + 5时腔体积增加和强化≥5%与生存期缩短相关，提示放射学异常增加<25%可能预测生存期。
