Pseudoprogression as an adverse event of glioblastoma therapy

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...

Descripción completa

Detalles Bibliográficos
Autores: Balana, C, Capellades, J, Pineda, E, Estival, A, Puig, J, Domenech, S, Verger, E, Pujol, T, Martinez-Garcia, M, Oleaga, L, Velarde, J, Mesia, C, Fuentes, R, Marruecos, J, Del Barco, S, Villa, S, Carrato, C, Gallego, O, Gil-Gil, M, Craven-Bartle, J, Alameda, F
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p5964
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=5964
Access Level:acceso abierto
Palabra clave:Glioblastoma
IDH1 mutation
imaging
MGMT
pseudoprogression
radionecrosis
Descripción
Sumario: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.