van West Sophie E, de Bruin Hein G, van de Langerijt Bart, Swaak-Kragten Annemarie T, van den Bent Martin J, Taal Walter
Department of Neuro-oncology/Neurology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.
Department of Radiology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.
Neuro Oncol. 2017 May 1;19(5):719-725. doi: 10.1093/neuonc/now194.
As the incidence of pseudo-progressive disease (psPD), or pseudoprogression, in low-grade glioma (LGG) is unknown, we retrospectively investigated this phenomenon in a cohort of LGG patients given radiotherapy (RT).
All MRI scans and clinical data from patients with histologically proven LGG treated with radiation between 2000 and 2011 were reviewed. PsPD was scored when a new enhancing lesion occurred after RT and subsequently disappeared or remained stable for at least a year without therapy, including dexamethasone.
Sixty-three out of 71 patients who received RT for LGG were deemed eligible for evaluation of psPD. The median follow-up was 5 years (range 1‒10 y). PsPD was seen in 13 patients (20.6%). PsPD occurred after a median of 12 months with a range of 3-78 months. The median duration of psPD was 6 months, with a range of 2-26 months and always occurred within the RT high dose fields of at least 45 Gy. The area of the enhancement at the time of psPD was significantly smaller compared with the area of enhancement during "true" progression (median size 54mm2 [range 12-340mm2] vs 270mm2 [range 30-3420mm2], respectively; P = .009).
PsPD occurs frequently in LGG patients receiving RT. This supports the policy to postpone a new line of treatment until progression is evident, especially when patients have small contrast enhancing lesions within the RT field.
由于低级别胶质瘤（LGG）中假性进展性疾病（psPD）或假性进展的发生率尚不清楚，我们对一组接受放疗（RT）的LGG患者进行了回顾性研究。
回顾了2000年至2011年间接受放疗的组织学确诊LGG患者的所有MRI扫描和临床数据。当放疗后出现新的强化病灶，随后未经治疗（包括地塞米松）而消失或至少稳定一年时，对psPD进行评分。
71例接受LGG放疗的患者中有63例被认为符合psPD评估条件。中位随访时间为5年（范围1至10年）。13例患者（20.6%）出现psPD。psPD发生的中位时间为12个月，范围为3至78个月。psPD的中位持续时间为6个月，范围为2至26个月，且总是发生在至少45 Gy的放疗高剂量区域内。与“真正”进展期间的强化面积相比，psPD时的强化面积明显较小（中位大小分别为54mm²[范围12至340mm²]和270mm²[范围30至3420mm²]；P = 0.009）。
接受放疗的LGG患者中psPD经常发生。这支持了在进展明显之前推迟新的治疗方案的策略，特别是当患者在放疗区域内有小的强化病灶时。
