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Curr Oncol. 2012 Aug;19(4):e295-8. doi: 10.3747/co.19.983.

Does neurologic deterioration help to differentiate between pseudoprogression and true disease progression in newly diagnosed glioblastoma multiforme?

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  • 1Division of Neuro Oncology, Department of Oncology, Tom Baker Cancer Centre, Calgary AB.

Abstract

Enlarging or new lesions frequently appear on magnetic resonance imaging (mri) after concurrent administration of radiation therapy and temozolomide in glioblastoma multiforme (gbm) patients. However, in nearly half such cases, the observed radiologic changes are not due to true disease progression, but instead are a result of a post-radiation inflammatory state called "pseudoprogression." Retrospective studies have reported that neurologic deterioration at the time of the post-chemoradiotherapy mri is found more commonly in patients with true disease progression. We report a gbm patient with both radiologic progression on the post-chemoradiotherapy mri and concomitant neurologic deterioration, and we caution against incorporating clinical deterioration into the management schema of patients with possible pseudoprogression.

KEYWORDS:

Pseudoprogression; chemotherapy; disease progression; glioblastoma multiforme; mri; neurologic deterioration; radiation therapy; temozolomide

PMID:
22876160
PMCID:
PMC3410843
DOI:
10.3747/co.19.983
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