Immediate post-radiotherapy changes in malignant glioma can mimic tumor progression.
To determine the frequency of progressive MRI lesions shortly after radiotherapy for glioma with spontaneous improvement or stabilization, the authors studied a cohort of patients treated within two prospective phase III trials with radiotherapy only. In 9 out of 32 patients, the first post-radiotherapy MRI showed progressive enhancement. In 3 of these 9 the MRI improved or stabilized for 6 months without additional treatment. The authors conclude that patients with progressive lesions within 3 months after radiotherapy should not be eligible for phase II trials on recurrent glioma.
de Wit
M C Y
MC
Department of Neuro-oncology/Neurology, Daniel den Hoed Cancer Center/Erasmus Medical Center, Rotterdam, The Netherlands.
de Bruin
H G
HG
Eijkenboom
W
W
Sillevis Smitt
P A E
PA
van den Bent
M J
MJ
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D016477:Artifacts; D001254:Astrocytoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D001929:Brain Edema / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D017326:Clinical Trials, Phase III as Topic / Q000592:standards; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003287:Contrast Media; D016371:Cranial Irradiation; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003907:Dexamethasone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D005910:Glioma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008130:Lomustine / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011344:Procarbazine / Q000008:administration & dosage; D000077204:Temozolomide; D014750:Vincristine / Q000008:administration & dosage
D003287:Contrast Media; D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine; D003606:Dacarbazine; D003907:Dexamethasone; D005682:Gadolinium; D000077204:Temozolomide