Pseudoprogression as an adverse event of glioblastoma therapy
Por:
Balana, C, Capellades, J, Pineda, E, Estival, A, Puig, J, Domenech, S, Verger, E, Pujol, T, Martinez-Garcia, M, Oleaga, L, Velarde, J, Mesia, C, Fuentes, R, Marruecos, J, Del Barco, S, Villa, S, Carrato, C, Gallego, O, Gil-Gil, M, Craven-Bartle, J, Alameda, F
Publicada:
1 dic 2017
Resumen:
We explored predictive factors of pseudoprogression (PsP) and its impact on prognosis in a retrospective series of uniformly treated glioblastoma patients. Patients were classified as having PsP, early progression (eP) or neither (nP). We examined potential associations with clinical, molecular, and basal imaging characteristics and compared overall survival (OS), progression-free survival (PFS), post-progression survival (PPS) as well as the relationship between PFS and PPS in the three groups. Of the 256 patients studied, 56 (21.9%) were classified as PsP, 70 (27.3%) as eP, and 130 (50.8%) as nP. Only MGMT methylation status was associated to PsP. MGMT methylated patients had a 3.5-fold greater possibility of having PsP than eP (OR: 3.48; 95% CI: 1.606-7.564; P=0.002). OS was longer for PsP than eP patients (18.9 vs. 12.3months; P=0.0001) but was similar for PsP and nP patients (P=0.91). OS was shorter-though not significantly sofor PsP than nP patients (OS: 19.5 vs. 27.9months; P=0.63) in methylated patients. PPS was similar for patients having PsP, eP or nP (PPS: 7.2 vs. 5.4 vs. 6.7; P=0.43). Neurological deterioration occurred in 64.3% of cases at the time they were classified as PsP and in 72.8% of cases of eP (P=0.14). PsP confounds the evaluation of disease and does not confer a survival advantage in glioblastoma.
Filiaciones:
Balana, C:
ICO, Med Oncol, Barcelona, Spain
Capellades, J:
Hosp Mar, Radiol, Barcelona, Spain
Pineda, E:
Hosp Clin Barcelona, Med Oncol, Barcelona, Spain
Estival, A:
ICO, Med Oncol, Barcelona, Spain
Puig, J:
Hosp Univ Dr Josep Trueta, IDI, Biomed Res Inst IDIBGI, Imaging Res Unit, Girona, Spain
Domenech, S:
IDI, Radiol, Barcelona, Spain
Verger, E:
Hosp Clin Barcelona, Radiat Oncol, Barcelona, Spain
Pujol, T:
Hosp Clin Barcelona, Radiol, Barcelona, Spain
Martinez-Garcia, M:
Hosp Mar, Med Oncol, Barcelona, Spain
Oleaga, L:
Hosp Clin Barcelona, Radiol, Barcelona, Spain
Velarde, J:
ICO, Stat, Barcelona, Spain
Mesia, C:
ICO, Med Oncol, IDIBELL, Barcelona, Spain
Fuentes, R:
ICO, Radiat Oncol, Girona, Spain
Marruecos, J:
ICO, Radiat Oncol, Girona, Spain
Del Barco, S:
ICO, Med Oncol, Girona, Spain
Villa, S:
ICO, Radiat Oncol, Stat, Barcelona, Spain
Carrato, C:
Hosp Badalona Germans Trias & Pujol, Pathol, Badalona, Spain
Gallego, O:
Hosp Santa Creu & Sant Pau, Med Oncol, Barcelona, Spain
Gil-Gil, M:
ICO, Med Oncol, IDIBELL, Barcelona, Spain
Craven-Bartle, J:
Hosp Santa Creu & Sant Pau, Radiat Oncol, Barcelona, Spain
Alameda, F:
Hosp Mar, Pathol, Barcelona, Spain
Gold, Green Published
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