Oshima Sonoko, Hagiwara Akifumi, Raymond Catalina, Wang Chencai, Cho Nicholas S, Lu Jianwen, Eldred Blaine S C, Nghiemphu Phioanh L, Lai Albert, Telesca Donatello, Salamon Noriko, Cloughesy Timothy F, Ellingson Benjamin M
UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, California, USA.
Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Neurooncol Adv. 2023 Jul 9;5(1):vdad084. doi: 10.1093/noajnl/vdad084. eCollection 2023 Jan-Dec.
Alterations in tumor growth rate (TGR) in recurrent glioblastoma (rGBM) after treatment may be useful for identifying therapeutic activity. The aim of this study was to assess the impact of volumetric TGR alterations on overall survival (OS) in rGBM treated with chemotherapy with or without radiation therapy (RT).
Sixty-one rGBM patients treated with chemotherapy with or without concomitant radiation therapy (RT) at 1st or 2nd recurrence were retrospectively examined. Pre- and post-treatment contrast enhancing volumes were computed. Patients were considered "responders" if they reached progression-free survival at 6 months (PFS6) and showed a decrease in TGR after treatment and "non-responders" if they didn't reach PFS6 or if TGR increased.
Stratification by PFS6 and based on TGR resulted in significant differences in OS both for all patients and for patients without RT ( < 0.05). A decrease of TGR ( = 0.009), smaller baseline tumor volume ( = 0.02), O-methylguanine-DNA methyltransferase promoter methylation ( = 0.048) and fewer number of recurrences ( = 0.048) were significantly associated with longer OS after controlling for age, sex and concomitant RT.
A decrease in TGR in patients with PFS6, along with smaller baseline tumor volume, were associated with a significantly longer OS in rGBM treated with chemotherapy with or without radiation. Importantly, all patients that exhibited PFS6 also showed a measurable decrease in TGR.
复发性胶质母细胞瘤（rGBM）治疗后肿瘤生长速率（TGR）的改变可能有助于确定治疗活性。本研究的目的是评估容积性TGR改变对接受化疗联合或不联合放射治疗（RT）的rGBM患者总生存期（OS）的影响。
回顾性研究61例在首次或第二次复发时接受化疗联合或不联合同步放射治疗（RT）的rGBM患者。计算治疗前和治疗后增强扫描的体积。如果患者在6个月时达到无进展生存期（PFS6）且治疗后TGR降低，则被视为“反应者”；如果未达到PFS6或TGR升高，则被视为“无反应者”。
按PFS6分层并基于TGR，所有患者以及未接受RT的患者在OS方面均存在显著差异（<0.05）。在控制年龄、性别和同步RT后，TGR降低（=0.009）、基线肿瘤体积较小（=0.02）、O-甲基鸟嘌呤-DNA甲基转移酶启动子甲基化（=0.048）以及复发次数较少（=0.048）与较长的OS显著相关。
PFS6患者的TGR降低，以及基线肿瘤体积较小，与接受化疗联合或不联合放射治疗的rGBM患者的OS显著延长相关。重要的是，所有表现出PFS6的患者TGR也均有可测量的降低。
