NIMG-60TREATMENT RESPONSE KINETICS AND EXCEPTIONAL SURVIVAL IN GLIOBLASTOMA

Le résumé fourni par la source

Although glioblastoma (GBM) is considered a uniformly fatal disease, roughly 2-5% of GBM patients survive longer than 5 years. In this study, we sought to elucidate how response to treatment may be similar or different in long-term survivors (LTS) defined as living longer than 3 years (n = 12) versus patients with typical overall survival (<3 years) (n = 36). Pre-treatment, response to radiation, time to minimum volume, and post-treatment tumor growth kinetics were compared. Newly diagnosed GBM patients with 2 pre-treatment MRIs and 1 post-treatment MRI treated with adjuvant chemoradiation were included. Patients were classified by overall survival: LTS >3 years and the typical cohort as <3 years. Tumor kinetics were calculated as the difference in radius divided by number of days between scans. We investigated pretreatment characteristics of the two groups and found no significant (SD) in age (p = 0.30), RPA-score (p = 0.16), or pre-treatment tumor growth (LTS 45 mm/year vs typical patient, 258 mm/year, p= 0.33). The response to radiation was compared using the average radial velocity during radiation; there was no SD (-5.9 vs -9.7 mm/year; p= 0.715). Post-radiation, LTS exhibit a significantly (p = 0.021) slower rate of tumor growth (-1.095 versus 6.205 mm/year). Furthermore, the time for the tumor to reach its minimum size is significantly longer in those with exceptional OS (668.30 vs. 158.47 days, p= 0.020). If the tumor phenotype is manifested in the growth kinetics, these results suggest that the difference between LTS and average OS is contingent on the ability to control the tumor after adjuvant therapy, and not in differences that were present prior to intervention. The concept that treatment has selected for a different, less aggressive phenotype compels investigation of any molecular or other pre-treatment features predictive of this result.

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