Journal Article

FZJ-2024-02308

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Diagnosing pseudoprogression in glioblastoma: A challenging clinical issue

Galldiks, N.FZJ*

2024
Oxford Univ. Press Oxford

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Please use a persistent id in citations: doi:10.1093/nop/npad078

Abstract: Pseudoprogression refers to the transient worsening of radiographic features on anatomical MRI after glioblastoma treatment, especially following radiotherapy combined with alkylating agents. This phenomenon mimics tumor progression, leading to misinterpretation and potentially premature adjustments to the ongoing treatment. Importantly, consequences of misinterpreting pseudoprogression may be profound. Patients may be subjected to unnecessary changes in treatment, including premature discontinuation of therapies that could potentially be beneficial or to overestimation of the efficacy of the subsequent therapy. Moreover, the emotional burden on patients and their families cannot be overstated.Distinguishing between actual tumor progression and pseudoprogression remains clinically challenging. More accurate diagnostic tools, such as positron emission tomography using radiolabeled amino acids1–3 and advanced MRI such as perfusion-weighted imaging,4 may add valuable additional diagnostic information in a considerable fraction of patients.In the study by Blakstad and colleagues recently published in Neuro-Oncology Practice,5 284 glioblastoma patients who underwent radiotherapy (100%) with concomitant (95%) and adjuvant temozolomide chemotherapy over ≤6 cycles (92%) and subsequent MRI follow-up scans were evaluated regarding the incidence and clinical significance of pseudoprogression using the Response Assessment in Neuro-Oncology Working Group criteria.6 Confirmation MRI scans during follow-up were used to verify the initial MRI findings post-radiation allowing, for example, the reclassification from progressive disease to pseudoprogression when follow-up MRI changes stabilized or regressed without change in treatmen

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Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)

Research Program(s):

1. 5252 - Brain Dysfunction and Plasticity (POF4-525) (POF4-525)

Appears in the scientific report 2024

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Database coverage:
; Clarivate Analytics Master Journal List ; Ebsco Academic Search ; Emerging Sources Citation Index ; IF < 5 ; JCR ; SCOPUS ; Web of Science Core Collection

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