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Eur J Neurol. 2013 Oct;20(10):1335-41. doi: 10.1111/ene.12192. Epub 2013 May 17.

Defining pseudoprogression in glioblastoma multiforme.

Author information

1
Leuven Cancer Institute, KU Leuven and University Hospitals Leuven, Leuven, Belgium.

Abstract

BACKGROUND AND PURPOSE:

Pseudoprogression is a frequent phenomenon observed since the introduction of postoperative therapy with radiotherapy and temozolomide (RT/TMZ) in glioblastoma multiforme (GBM) patients. However, the criteria defining pseudoprogression, its incidence, the time of occurrence and its impact on therapy and outcome remain poorly defined.

METHODS:

The objective of this study is to compare two sets of criteria (liberal and stringent), defining pseudoprogression, in a cohort of patients treated before and after the introduction of RT/TMZ in the standard postoperative treatment. This retrospective review includes 136 unselected and consecutively treated patients with pathologically diagnosed GBM.

RESULTS:

Pseudoprogression was observed in 10 (12%) cases applying the stringent criteria, and in 18 (23%) patients when using the liberal criteria, in the cohort treated with RT/TMZ. Pseudoprogression was observed in only one patient treated with RT alone. The median time to pseudoprogression was 4 weeks after the end of RT. Patients with pseudoprogression had a median survival time of 28 months, compared with 12 months for patients without pseudoprogression.

CONCLUSIONS:

The incidence of pseudoprogression after RT/TMZ strongly depends on the applied criteria. However, regardless of the stringency of the criteria, the impact on survival remains the same.

KEYWORDS:

chemotherapy; glioblastoma; pseudoprogression; radiotherapy; temozolomide

PMID:
23679051
DOI:
10.1111/ene.12192
[Indexed for MEDLINE]

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