title: Impact of Angiotensin-II receptor blockers on vasogenic edema in glioblastoma patients.
abstract: Glioblastoma patients often require chronic administration of steroids due to peri-tumoral edema. Preliminary studies showed that treatment with Angiotensin-II Receptor Blockers (ARBs) for high blood pressure might be associated with reduced peri-tumoral edema. In this study, we aim to radiologically assess the effect of ARBs on peri-tumoral edema. We conducted a cross-sectional survey on patients with newly diagnosed GBM. Patients treated with ARBs for high blood pressure were paired to non ARB-treated patients based on similar age, tumor location and tumor size. Patients taking steroids at the time of pre-operative Magnetic Resonance Imaging were excluded from the study. In each pair of patients, we compared the volumes of peri-tumoral hyper T2-Fluid Attenuated Inversion Recovery (FLAIR) signal and the Apparent Diffusion Coefficient (ADC) in the same area. Eleven (11) ARB-treated patients were selected and paired to 11 non ARB-treated controls. Volumes of peri-tumoral hyper T2-FLAIR signal were significantly lower in the ARB-treated group than in the non ARB-treated group (p = 0.02). Additionally, peri-tumoral ADCs were also significantly lower in the treated group (p = 0.02), suggesting that the peri-tumoral area in this group had less edematous features. These results suggest that ARBs may reduce the volume of peri-tumoral hyper T2-FLAIR signal by decreasing edema.
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurologie, de l'Hôpital Avicenne, 125 route de Stalingrad, 93009, Bobigny, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Kourilsky
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service de radiologie, Hôpital Avicenne, 93009, Bobigny, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bertrand
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurologie, de l'Hôpital Avicenne, 125 route de Stalingrad, 93009, Bobigny, France.
authors.forename: Renata
authors.initials: R
authors.lastname: Ursu
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurologie, de l'Hôpital Avicenne, 125 route de Stalingrad, 93009, Bobigny, France.|UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, 93009, Bobigny, France.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Doridam
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurologie, de l'Hôpital Avicenne, 125 route de Stalingrad, 93009, Bobigny, France.|UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, 93009, Bobigny, France.
authors.forename: Ciprian
authors.initials: C
authors.lastname: Barlog
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurochirurgie, Hôpital Beaujon, 92110, Clichy, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Faillot
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurochirurgie, Hôpital Lariboisière, 75010, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mandonnet
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurologie, de l'Hôpital Avicenne, 125 route de Stalingrad, 93009, Bobigny, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Belin
authors.affiliation: Service de radiothérapie, IRHE, Hôpital Avicenne, 93009, Bobigny, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Levy
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurologie, de l'Hôpital Avicenne, 125 route de Stalingrad, 93009, Bobigny, France. antoine.carpentier@aphp.fr.|UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, 93009, Bobigny, France. antoine.carpentier@aphp.fr.
authors.forename: Antoine F
authors.initials: AF
authors.lastname: Carpentier
mesh_terms: D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005909:Glioblastoma / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D057911:Angiotensin Receptor Antagonists
keywords: ADC; Angiotensin receptor blockers; Edema; FLAIR; Glioblastoma