Pseudoprogression as an adverse event of glioblastoma therapy
Pseudoprogression as an adverse event of glioblastoma therapy
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DOI：
10.1002/cam4.1242
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发表时间：
2017-12-01
期刊：
影响因子：
4
通讯作者：
Alameda, Francesc
中科院分区：
文献类型：
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作者：
Balana, Carmen;Capellades, Jaume;Alameda, Francesc
我们在一系列经过统一治疗的胶质母细胞瘤患者的回顾性研究中探讨了假性进展 (PsP) 的预测因素及其对预后的影响。患者被分类为患有 PsP、早期进展 (eP) 或两者均无 (nP)。我们检查了与临床、分子和基础影像学特征的潜在关联，并比较了三组的总生存期 (OS)、无进展生存期 (PFS)、进展后生存期 (PPS) 以及 PFS 和 PPS 之间的关系。在研究的 256 名患者中，56 名 (21.9%) 被归类为 PsP，70 名 (27.3%) 被归类为 eP，130 名 (50.8%) 被归类为 nP。仅 MGMT 甲基化状态与 PsP 相关。 MGMT甲基化患者患PsP的可能性是eP的3.5倍（OR：3.48；95% CI：1.606-7.564；P=0.002）。 PsP 患者的 OS 比 eP 患者长（18.9 个月与 12.3 个月；P=0.0001），但 PsP 和 nP 患者的 OS 相似（P=0.91）。甲基化患者中，PsP 患者的 OS 比 nP 患者短，但不显着（OS：19.5 个月与 27.9 个月；P=0.63）。 PsP、eP 或 nP 患者的 PPS 相似（PPS：7.2 vs. 5.4 vs. 6.7；P=0.43）。 64.3% 的病例在被分类为 PsP 时发生神经功能恶化，72.8% 的 eP 病例发生神经功能恶化 (P=0.14)。 PsP 混淆了疾病的评估，并且不赋予胶质母细胞瘤生存优势。
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.