Abstract
The aim of the present study was to evaluate the impact of first-line radiotherapy on low-grade gliomas (LGGs) growth kinetics. The mean tumor diameter (MTD) of 39 LGGs was retrospectively measured on serial magnetic resonance images before (n = 16) and after radiotherapy onset (n = 39). After radiotherapy, a decrease of the MTD was observed in 37 patients. Median duration of the MTD decrease was 1.9 years (range 0–8.1 years). According to RANO criteria, the rates of partial and minor responses were 15 and 28 % at the first evaluation after radiotherapy and 36 and 34 % at the time of maximal MTD decrease. The presence of a 1p19q codeletion and the absence of p53 expression were associated with longer durations of MTD decrease (5.3 vs 1 years, p = 0.02 and 2.4 vs 1.8 years, p = 0.05, respectively) while no association was observed between IDH1-R132H expression and duration of MTD decrease. In most patients, MTD decrease after radiotherapy occurred in two phases: an initial phase of rapid MTD decrease followed by a second phase of slower MTD decrease. Patients with a high rate of MTD decrease during the initial phase (>7 mm/year) had both a shorter duration of response (1.9 vs 5.3 years, p = 0.003) and a shorter overall survival (5.5 vs 11.6 years, p = 0.0004). LGGs commonly display a prolonged and ongoing volume decrease after radiotherapy. However, patients who respond rapidly should be carefully monitored because they are at a higher risk of rapid progression.
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The authors wish to acknowledge Johan Pallud for valuable discussions and Marie Aline Renard for her valuable help collecting data.
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11060_2013_1224_MOESM1_ESM.tif
Supplementary material 1 (TIFF 108 kb). Observed MTD values versus individual predicted MTD values using mathematical modeling. The MTD decrease after radiotherapy was modeled using the Monolix software (Lixoft) based on the hypothesis that treatment response consisted of a single phase of linear decrease (y = ax +b) or of two distinct phases of linear decrease (y = a1x + b followed by y = a2x + c). As shown, the model based on the two phase hypothesis (right) was much more accurate than the model based on the single phase hypothesis (left)
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Ducray, F., Kaloshi, G., Houillier, C. et al. Ongoing and prolonged response in adult low-grade gliomas treated with radiotherapy. J Neurooncol 115, 261–265 (2013). https://doi.org/10.1007/s11060-013-1224-1
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DOI: https://doi.org/10.1007/s11060-013-1224-1