Aims and objectives
The critical biological characteristic of a Glioblastoma (GBM) is an inevitable progression after standard therapy with survival less than one year (mean 6,9 months) from the time of diagnosis.
Tumor recurrence develops in almost all patients despite the aggressive standard first line treatment with radiotherapy and concomitant or adjuvant temozolomide (RT + TMZ).
Thus,
prediction of poor treatment response (early relapse) to the standard first line treatment of GBM is of high clinical significance,
especially in the view of new emerging salvage treatment options such...
Methods and materials
Study population:
27 patients with recurrent GBM were selected from the local database for the period from 2012 to 2018 and enrolled in the retrospective study.
The recurrence was proven either with surgical biopsy or MRI surveillance.
Prior to the relapse event all patients undergone gross tumor resection and received Intensity Modulated radiation therapy (IMRT) combined with concurrent or adjuvant temozolomide as a primary treatment of high-grade Glioblastoma.
Data acquisition:
MR spectroscopy (MRS) and apparent diffusion coefficient (ADC) parameters of pretreatment (baseline) diagnostic studies were...
Results
Total of 27 patients with GBM progression on the structural MRI were retrospectively included into this study.The basic characteristics of the study sample are summarized in Table 1.
The study sample was divided into two subgroups of early (less then 4 months) and late (over 4 months) recurrence.
Thirteen patients presented with early relapse within 4 months after the end of IMRT; fourteen patients developed late recurrence (5 – 72 months).
The independent-samples Mann-Whitney U test (Table 3) showed significant (p value 0.000) difference between...
Conclusion
Baseline Glioblastoma MRS parameters have predictive potential in early vs late recurrence patient stratification.
The predictive capacity of acquired logistic regression model provides the possibility to develop a scoring system by weighting dummy-coded variables and assigning scores to each MRSI and DWI parameter.
Therefore we plan on inter-institutional expansion of the study cohort to apply the scoring system of acquired cut-offs and validate the accuracy in a prospective multi-institutional study.
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