Updated Response Assessment Criteria for High-Grade Gliomas: Response Assessment in Neuro-Oncology Working Group

被引:3021
作者
Wen, Patrick Y. [1 ]
Macdonald, David R.
Reardon, David A.
Cloughesy, Timothy F.
Sorensen, A. Gregory
Galanis, Evanthia
DeGroot, John
Wick, Wolfgang
Gilbert, Mark R.
Lassman, Andrew B.
Tsien, Christina
Mikkelsen, Tom
Wong, Eric T.
Chamberlain, Marc C.
Stupp, Roger
Lamborn, Kathleen R.
Vogelbaum, Michael A.
van den Bent, Martin J.
Chang, Susan M.
机构
[1] Dana Farber Brigham & Womens Canc Ctr, Ctr Neurooncol, Boston, MA 02115 USA
关键词
RECURRENT MALIGNANT GLIOMA; MAGNETIC-RESONANCE-SPECTROSCOPY; BEVACIZUMAB PLUS IRINOTECAN; ADULT BRAIN-TUMORS; GLIOBLASTOMA PATIENTS; PHASE-II; CLINICAL-APPLICATIONS; CONTRAST ENHANCEMENT; RADIATION-THERAPY; IMAGING CHANGES;
D O I
10.1200/JCO.2009.26.3541
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
Currently, the most widely used criteria for assessing response to therapy in high-grade gliomas are based on two-dimensional tumor measurements on computed tomography (CO or magnetic resonance imaging (MRI), in conjunction with clinical assessment and corticosteroid dose (the Macdonald Criteria). It is increasingly apparent that there are significant limitations to these criteria, which only address the contrast-enhancing component of the tumor. For example, chemoradiotherapy for newly diagnosed glioblastomas results in transient increase in tumor enhancement (pseudoprogression) in 20% to 30% of patients, which is difficult to differentiate from true tumor progression. Antiangiogenic agents produce high radiographic response rates, as defined by a rapid decrease in contrast enhancement on CT/MRI that occurs within days of initiation of treatment and that is partly a result of reduced vascular permeability to contrast agents rather than a true antitumor effect. In addition, a subset of patients treated with antiangiogenic agents develop tumor recurrence characterized by an increase in the nonenhancing component depicted on T2-weighted/fluid-attenuated inversion recovery sequences. The recognition that contrast enhancement is nonspecific and may not always be a true surrogate of tumor response and the need to account for the nonenhancing component of the tumor mandate that new criteria be developed and validated to permit accurate assessment of the efficacy of novel therapies. The Response Assessment in Neuro-Oncology Working Group is an international effort to develop new standardized response criteria for clinical trials in brain tumors. In this proposal, we present the recommendations for updated response criteria for high-grade gliomas.
引用
收藏
页码:1963 / 1972
页数:10
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