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03.06.2016 | Original Article

MRI during radiotherapy of glioblastoma

Does MRI allow for prognostic stratification?

verfasst von: Dr. C. Leitzen, T. Wilhelm-Buchstab, L. C. Schmeel, S. Garbe, S. Greschus, T. Müdder, S. Oberste-Beulmann, B. Simon, H. H. Schild, H. Schüller

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 7/2016

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Abstract

Aim

To evaluate the role of magnetic resonance imaging (MRI) as a predictor for the clinical course in patients with glioblastoma.

Patients and methods

In 64 patients with glioblastoma undergoing (chemo)radiotherapy MRI studies were obtained before radiation, after 30 gray (Gy), after 60 Gy and during follow-up. MRI findings were assigned to categories: definite progression, questionable progression, no change. Patients were followed clinically.

Results

At 30 Gy, 23 of 64 patients (36 %) demonstrated definite (dp; n = 15) or questionable (qp; n = 8) progression; in 41/64 (64 %) no change was found compared with preradiation MRI. After radiotherapy at 60 Gy, 26 of 64 (41 %) patients showed dp (n = 18) or qp (n = 8). In 2 cases with qp at the 30 Gy MRI, progress was unquestionable in the 60 Gy MRI study. In the 64 patients, 5 of the 60 Gy MRIs showed dp/qp after being classified as no change at the 30 Gy MRI, 2 of the 30 Gy MRIs showed qp, while the 60 Gy MRI showed tumour regression and 3 fulfilled the criteria for pseudoprogression during ongoing radiotherapy. The 30 Gy study allowed for prognostic stratification: dp/qp compared to stable patients showed median survival of 10.5 versus 20 months.

Conclusion

MR follow-up after 30 Gy in patients undergoing (chemo)radiotherapy for glioblastoma allows prognostic appraisal. Pseudoprogression has to be taken into account, though rare in our setting. Based on these findings, early discussion of treatment modification is possible.

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Titel: MRI during radiotherapy of glioblastoma
Does MRI allow for prognostic stratification?
verfasst von: Dr. C. Leitzen
T. Wilhelm-Buchstab
L. C. Schmeel
S. Garbe
S. Greschus
T. Müdder
S. Oberste-Beulmann
B. Simon
H. H. Schild
H. Schüller
Publikationsdatum: 03.06.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 7/2016
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-0983-y

Neu im Fachgebiet Onkologie

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MRI during radiotherapy of glioblastoma

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Abstract

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Patients and methods

Results

Conclusion

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Patients and methods

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