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@ARTICLE{Flies:1023537,
      author       = {Flies, Christina Maria and Friedrich, Michel and Lohmann,
                      Philipp and van Garderen, Karin Alida and Smits, Marion and
                      Tonn, Joerg-Christian and Weller, Michael and Galldiks,
                      Norbert and Snijders, Tom Jan},
      title        = {{T}reatment-associated imaging changes in newly diagnosed
                      {MGMT} promoter-methylated glioblastoma undergoing
                      chemoradiation with or without cilengitide},
      journal      = {Neuro-Oncology},
      volume       = {26},
      number       = {5},
      issn         = {1522-8517},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {FZJ-2024-01743},
      pages        = {902-910},
      year         = {2024},
      abstract     = {Background: Radiological progression may originate from
                      progressive disease (PD) or
                      pseudoprogression/treatment-associated changes. We assessed
                      radiological progression in MGMT promoter-methylated
                      glioblastoma treated with standard-of-care chemoradiotherapy
                      with or without the integrin inhibitor cilengitide according
                      to the modified RANO criteria of 2017.Methods: Patients with
                      ≥3 follow-up MRIs were included. Preliminary PD was
                      defined as a $≥25\%$ increase of the sum of products of
                      perpendicular diameters (SPD) of a new or increasing lesion
                      compared to baseline. PD required a second $≥25\%$
                      increase of the SPD. Treatment-associated changes required
                      stable or regressing disease after preliminary PD.Results:
                      Of the 424 evaluable patients, 221 patients $(52\%)$ were
                      randomized into the cilengitide, and 203 patients $(48\%)$
                      into the control arm. After chemoradiation with or without
                      cilengitide, preliminary PD occurred in 274 patients
                      $(65\%)$ during available follow-up, and 88 of these
                      patients $(32\%)$ had treatment-associated changes, whereas
                      67 patients $(25\%)$ had PD. The remaining 119 patients
                      $(43\%)$ had no further follow-up after preliminary PD.
                      Treatment-associated changes were more common in the
                      cilengitide arm than in the standard-of-care arm $(24\%$ vs.
                      $17\%;$ relative risk, 1.3; $95\%$ confidence interval,
                      1.004-1.795; p=0.047). Treatment-associated changes occurred
                      mainly during the first six months after RT $(54\%$ after
                      three months vs. $13\%$ after six months).Conclusion: With
                      the modified RANO criteria, the rate of treatment-associated
                      changes was low compared to previous studies in MGMT
                      promoter-methylated glioblastoma. This rate was higher after
                      cilengitide compared to standard-of-care treatment.
                      Confirmatory scans, as recommended in the modified RANO
                      criteria, were not always available reflecting current
                      clinical practice.Keywords: glioma; modified RANO criteria;
                      pseudoprogression; temozolomide.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {5252 - Brain Dysfunction and Plasticity (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5252},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {38219019},
      UT           = {WOS:001154554300001},
      doi          = {10.1093/neuonc/noad247},
      url          = {https://juser.fz-juelich.de/record/1023537},
}