Changes in Relative Cerebral Blood Volume 1 Month after Radiation-Temozolomide Therapy Can Help Predict Overall Survival in Patients with Glioblastoma
Changes in Relative Cerebral Blood Volume 1 Month after Radiation-Temozolomide Therapy Can Help Predict Overall Survival in Patients with Glioblastoma
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DOI：
10.1148/radiol.10091440
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发表时间：
2010-08-01
期刊：
影响因子：
19.7
通讯作者：
Ekholm, Sven E.
中科院分区：
文献类型：
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作者：
Mangla, Rajiv;Singh, Gurshawn;Ekholm, Sven E.
目的：通过比较放疗加替莫唑胺联合治疗(RT-TMZ)前和治疗结束后1个月的MR灌注成像测量结果，评价多形性胶质母细胞瘤患者的血流灌注参数的变化。材料和方法：获得机构评审委员会批准，遵循HIPAA指南。回顾36例接受RT-TMZ治疗的多形性胶质母细胞瘤患者的临床资料。假设RT-TMZ术后1个月相对脑血容量(RCBV)的变化可以预测总存活率。采用线性回归分析肿瘤大小和血流参数的变化与总存活率之间的关系。受试者操作特征(ROC)曲线用于评估1年生存率。结果：RT-TMZ后1个月rCBV的变化百分比与总生存率相关。治疗后rCBV升高是预后不良的有力预测指标(中位生存期为235天，rCBV降低为529天)(P<；.008，对数等级检验)。1年生存率曲线下面积(0.806；95%可信区间[CI]：0.698，0.970)(P=0.005)大于肿瘤大小(0.556；95%可信区间：0.342，0.729)(P=.382)。根据Macdonald标准，肿瘤体积增大的患者的总生存期比没有进展的患者(稳定或部分缓解)要短，但差异不显著(中位生存期分别为442天和598天)(P=.761，LOG-RANK检验)。结论：RT-TMZ后rCBV的变化似乎与总生存期相关。(C)RSNA，2010年
Purpose: To evaluate perfusion parameter changes in patients with glioblastoma multiforme by comparing the perfusion magnetic resonance (MR) imaging measurements obtained before combined radiation and temozolomide therapy (RT-TMZ) with the follow-up MR imaging measurements obtained 1 month after completion of this treatment.Materials and Methods: Institutional review board approval was obtained, and HIPAA guidelines were followed. The data of 36 patients (24 male [median age, 63 years]; 12 female [median age, 59 years]) with glioblastoma multiforme who were treated with RT-TMZ were retrospectively reviewed. The hypothesis was that a change in relative cerebral blood volume (rCBV) 1 month after RT-TMZ is predictive of overall survival. Linear regression analysis was performed to correlate changes in tumor size and perfusion parameters with overall survival. Receiver operating characteristic (ROC) curves were evaluated for 1-year survival. Overall survival was assessed with Kaplan-Meir survival curves and log-rank testing.Results: Percentage change in rCBV at 1 month after RT-TMZ correlated with overall survival. Increased rCBV after treatment was a strong predictor of poor survival (median survival, 235 days versus 529 days with decreased rCBV) (P < .008, log-rank test). The ROC curves for 1-year survival showed a greater area under the curve (0.806; 95% confidence interval [CI]: 0.698, 0.970) (P = .005) with rCBV than with tumor size (0.556; 95% CI: 0.342, 0.729) (P = .382). The overall survival for patients with increased tumor size, based on Macdonald criteria, was shorter than that for patients who showed no progression (stable or partial response), but the difference was not significant (median survival, 442 days versus 598 days) (P = .761, log-rank test).Conclusion: Change in rCBV after RT-TMZ appears to correlate with overall survival. (C) RSNA, 2010