Sustained focal antitumor activity of bevacizumab in recurrent glioblastoma

被引:19
作者
Baehr, Oliver [1 ,5 ,6 ]
Harter, Patrick N. [2 ,5 ,6 ]
Weise, Lutz M. [3 ,5 ,6 ]
You, Se-Jong [4 ,5 ,6 ]
Mittelbronn, Michel [2 ,5 ,6 ]
Ronellenfitsch, Michael W. [1 ,5 ,6 ]
Rieger, Johannes [1 ,5 ,6 ]
Steinbach, Joachim P. [1 ,5 ,6 ]
Hattingen, Elke [4 ,5 ,6 ]
机构
[1] Goethe Univ Frankfurt, Univ Hosp Frankfurt, Dr Senckenberg Inst Neurooncol, D-60054 Frankfurt, Germany
[2] Goethe Univ Frankfurt, Univ Hosp Frankfurt, Inst Neurol, Edinger Inst, D-60054 Frankfurt, Germany
[3] Goethe Univ Frankfurt, Univ Hosp Frankfurt, Dept Neurosurg, D-60054 Frankfurt, Germany
[4] Goethe Univ Frankfurt, Univ Hosp Frankfurt, Inst Neuroradiol, D-60054 Frankfurt, Germany
[5] German Canc Consortium DKTK, Heidelberg, Germany
[6] German Canc Res Ctr, Heidelberg, Germany
关键词
MALIGNANT GLIOMAS; TUMOR PROGRESSION; SURROGATE MARKER; PATTERNS; INVASION; SURVIVAL; EFFICACY; RELAPSE;
D O I
10.1212/WNL.0000000000000594
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives: To investigate the relevance of bevacizumab (BEV)-induced diffusion-restricted lesions and T1-hyperintense lesions in patients with recurrent glioblastoma. Methods: We prospectively screened 74 BEV-treated patients with recurrent glioblastoma for (1) diffusion-restricted lesions and/or, (2) lesions with a hyperintense signal on precontrast T1-weighted images. We further evaluated overall survival (OS), histopathology of the lesions, and patterns of progression. Results: Twenty-five of 74 patients (34%) developed T1-hyperintense lesions, whereas diffusion-restricted lesions could be detected in 35 of 74 patients (47%). In 21 of 74 patients (28%), the lesions displayed both features ("double-positive"). OS for patients with double-positive lesions was 13.0 months; patients with neither of these lesions had an OS of 6.6 months (p < 0.005). Histologic evaluation of double-positive lesions revealed extensive calcified necrosis in 4 of 4 patients. Notably, these double-positive lesions were rarely involved in further tumor progression. However, they were associated with an increase in distant recurrences at BEV failure. Conclusions: BEV-induced double-positive MRI lesions are a predictive imaging marker associated with a substantial survival benefit and with improved local control in patients with recurrent glioblastoma. Our data suggest that these lesions are the result of a sustained focal antitumor activity of BEV.
引用
收藏
页码:227 / 234
页数:8
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