Erschienen in:
28.05.2018 | Original Article – Clinical Oncology
Tumor growth patterns of MGMT-non-methylated glioblastoma in the randomized GLARIUS trial
verfasst von:
Christina Schaub, Sied Kebir, Nina Junold, Elke Hattingen, Niklas Schäfer, Joachim P. Steinbach, Astrid Weyerbrock, Peter Hau, Roland Goldbrunner, Michael Niessen, Frederic Mack, Moritz Stuplich, Theophilos Tzaridis, Oliver Bähr, Rolf-Dieter Kortmann, Uwe Schlegel, Friederike Schmidt-Graf, Veit Rohde, Christian Braun, Mathias Hänel, Michael Sabel, Rüdiger Gerlach, Dietmar Krex, Claus Belka, Hartmut Vatter, Martin Proescholdt, Ulrich Herrlinger, Martin Glas
Erschienen in:
Journal of Cancer Research and Clinical Oncology
|
Ausgabe 8/2018
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Abstract
Background
We evaluated patterns of tumor growth in patients with newly diagnosed MGMT-non-methylated glioblastoma who were assigned to undergo radiotherapy in conjunction with bevacizumab/irinotecan (BEV/IRI) or standard temozolomide (TMZ) within the randomized phase II GLARIUS trial.
Methods
In 142 patients (94 BEV/IRI, 48 TMZ), we reviewed magnetic resonance imaging scans at baseline and first tumor recurrence. Based on contrast-enhanced T1-weighted and fluid-attenuated inversion recovery images, we assessed tumor growth patterns and tumor invasiveness. Tumor growth patterns were classified as either multifocal or local at baseline and recurrence; at first recurrence, we additionally assessed whether distant lesions appeared. Invasiveness was determined as either diffuse or non-diffuse. Associations with treatment arms were calculated using Fisher’s exact test.
Results
At baseline, 115 of 142 evaluable patients (81%) had a locally confined tumor. Between treatment arms, there was no significant difference in the fraction of tumors that changed from an initially local tumor growth pattern to a multifocal pattern (12 and 13%, p = 0.55). Distant lesions appeared in 17% (BEV/IRI) and 13% (TMZ) of patients (p = 0.69). 15% of patients in the BEV/IRI arm and 8% in the TMZ arm developed a diffuse growth pattern from an initially non-diffuse pattern (p = 0.42).
Conclusions
The tumor growth and invasiveness patterns do not differ between BEV/IRI and TMZ-treated MGMT-non-methylated glioblastoma patients in the GLARIUS trial. BEV/IRI was not associated with an increased rate of multifocal, distant, or highly invasive tumors at the time of recurrence.