Pseudoprogression in Patients With Glioblastoma Multiforme After Concurrent Radiotherapy and Temozolomide

  title={Pseudoprogression in Patients With Glioblastoma Multiforme After Concurrent Radiotherapy and Temozolomide},
  author={Erkan Topkan and Savaş Topuk and Ezgi Oymak and Cem Parlak and Berrin Pehlivan},
  journal={American Journal of Clinical Oncology},
BackgroundTo evaluate pathologically confirmed incidence of pseudoprogression and its impact on survival in glioblastoma multiforme (GBM) patients treated with radiotherapy and concurrent temozolomide (TMZ), followed by 6 months of TMZ maintenance therapy. Materials and MethodsSixty-three patients with histologic proof of GBM underwent 60 Gy (2 Gy/fr, 30 fractions) of brain radiotherapy concurrent with continuous 75 mg/m2/d TMZ, followed by 6 cycles of maintenance TMZ (200 mg/m2/d for 5 d… 

High levels of cellular proliferation predict pseudoprogression in glioblastoma patients

In GBM patients, the level of cellular proliferation (Ki67 indices) emerged as a statistically significant prognostic marker for distinguishing pseudoprogression from actual progression, suggesting that GBM associated with a high level of Cellular proliferation may differentiate tumor progression from Pseudo-progression.

Early Pseudoprogression following Chemoradiotherapy in Glioblastoma Patients: The Value of RANO Evaluation

In this cohort of glioblastoma patients following radiotherapy/temozolomide (RT/TMZ), the frequency of pseudoprogression varied between 13% and 24%, being overdiagnosed by older Macdonald criteria, which emphasizes the importance of RANO criteria and new radiological biomarkers for correct response evaluation.

Evaluation of pseudoprogression in patients with glioblastoma.

Of all conventional glioblastoma response criteria, the RANO criteria gave the lowest incidence of pseudoprogression, and patients with pseudiprogression did not have statistically significant difference in survival compared with patients with stable disease.

Histopathological correlates with survival in reoperated glioblastomas

The histopathological features defined here and used to assess the tumor at reoperation were independently associated with survival and may be important in designing treatment strategies and clinical trial endpoints for patients with glioblastoma.

Continuous Low-Dose Temozolomide Chemotherapy and Microvessel Density in Recurrent Glioblastoma

The efficacy of continuous low-dose TMZ chemotherapy is marginal and the need to develop further treatment strategies for recurrent and TMZ-refractory GBM is suggested.

Initial and cumulative recurrence patterns of glioblastoma after temozolomide-based chemoradiotherapy and salvage treatment: a retrospective cohort study in a single institution

Recurrence patterns of glioblastoma after radiotherapy plus concomitant and adjuvant temozolomide were mainly central at first, and distant recurrences were often detected during the clinical course, suggesting much better local control and prevention of distant recurrence, including effective salvage treatment, seem to be important.

Tumor recurrence or treatment-related changes following chemoradiation in patients with glioblastoma: does pathology predict outcomes?

A large retrospective study to analyze the clinical significance of histopathology following re-resection and its influence on genomic sequencing results and found Histopathologic findings following chemoradiation do not correlate with clinical outcomes.

Real-World Evidence in Glioblastoma: Stupp's Regimen After a Decade

The aim of this retrospective study is to provide real-world evidence in glioblastoma treatment and to compare overall survival after Stupp's regimen treatment today and a decade ago. A current

Proliferation Index Predicts Survival after Second Craniotomy within 6 Months of Adjuvant Radiotherapy for High-grade Glioma.



Pseudoprogression Following Chemoradiotherapy for Glioblastoma Multiforme

  • P. SangheraJ. Perry M. Tsao
  • Medicine
    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
  • 2010
Almost one third of patients with early progression were found to have psPD which was associated with a favourable prognosis and Maintenance TMZ should not be abandoned on the basis of seemingly discouraging imaging features identified within the first three months after RT/TMZ.

Population-Based Study of Pseudoprogression after Chemoradiotherapy in GBM

It is suggested that physicians should continue adjuvant TMZ in GBM patients when early MRI scans show evidence of progression following concurrent chemoradiotherapy, as up to 50% of these patients will experience radiologic stability or improvement in subsequent treatment cycles.

Pseudoprogression and MGMT status in glioblastoma patients: implications in clinical practice.

The PsPD phenomenon opens the prospect of a new era for the management of glioblastoma patients undergoing radio-chemotherapy, with the longest progression and survival times of all patients.

Pseudoprogression in patients with malignant gliomas treated with concurrent temozolomide and radiotherapy: potential role of p53

It is indicated that psPD following chemoradiotherapy with TMZ is associated with significantly better overall survival compared to that of ePD, and is comparable to nonPD group.

Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma.

The addition of temozolomide to radiotherapy for newly diagnosed glioblastoma resulted in a clinically meaningful and statistically significant survival benefit with minimal additional toxicity.

Promising survival for patients with newly diagnosed glioblastoma multiforme treated with concomitant radiation plus temozolomide followed by adjuvant temozolomide.

  • R. StuppP. Dietrich S. Leyvraz
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2002
This regimen of concomitant chemoradiotherapy followed by adjuvant chemotherapy may prolong the survival of patients with glioblastoma.

Evaluation of malignant glioma patients during the postirradiation period.

A retrospective study of 51 patients with supratentorial malignant gliomas who survived longer than 26 weeks from the time of diagnosis, finding that in the first 18 weeks after RT, 26 of the 51 patients studied showed deterioration in one or more tests; 14 of the 26 did not improve.

Radiation‐induced dementia in patients cured of brain metastases

It is believed that these fractionation schedules, several of which are used commonly, predispose to delayed neurologic toxicity, and that more protracted schedules should be employed for the safe and efficacious treatment of good-risk patients with brain metastases.