Treatment evaluation by volumetric segmentation in pediatric optic pathway glioma: evaluation of the effect of bevacizumab on intra-tumor components

Treatment evaluation by volumetric segmentation in pediatric optic pathway glioma: evaluation of the effect of bevacizumab on intra-tumor components

Purpose Progressive pediatric optic pathway gliomas (OPGs) are treated by diverse systemic antitumor modalities. Refined insights on the course of intra-tumoral components are limited. Methods We performed an exploratory study on the longitudinal volumetric course of different (intra-)tumor componen...

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Bibliographic Details
Published in:Journal of neuro-oncology Vol. 166; no. 1; pp. 79 - 87
Main Authors: Bennebroek, Carlien A., Schouten, Christiaan R., Montauban-van Swijndregt, Maartje C., Saeed, Peerooz, Porro, Giorgio L., Pott, Jan W. R., Dittrich, Anne T. M., Oostenbrink, Rianne, Schouten-van Meeteren, Antoinette Y., de Jong, Marcus C., de Graaf, Pim
Format: Journal Article
Language:English
Published: New York Springer US 2024
Springer Nature B.V
Subjects:
Bevacizumab
Bevacizumab - pharmacology
Bevacizumab - therapeutic use
Child
Cysts
Glioma
Humans
Image processing
Magnetic Resonance Imaging
Medicine
Medicine & Public Health
Neurofibromatosis 1
Neurology
Oncology
Optic Nerve Glioma - diagnostic imaging
Optic Nerve Glioma - drug therapy
Optic Nerve Glioma - pathology
Osteoprotegerin
Pediatrics
Proto-Oncogene Proteins B-raf
Segmentation
Tumors
Optic pathway glioma
Segmentation
MRI
Response assessment
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Summary:Purpose Progressive pediatric optic pathway gliomas (OPGs) are treated by diverse systemic antitumor modalities. Refined insights on the course of intra-tumoral components are limited. Methods We performed an exploratory study on the longitudinal volumetric course of different (intra-)tumor components by manual segmentation of MRI at the start and after 3, 6 and 12 months of bevacizumab (BVZ) treatment. Results Thirty-one patients were treated with BVZ (median 12 months, range: 2–39 months). During treatment the total tumor volume decreased with median 19.9% (range: − 62.3 to + 29.7%; n = 30) within the first 3 months, decreased 19.0% (range: − 68.8 to + 96.1%; n = 28) between start and 6 months and 27.2% (range: −73.4 to + 36.0%; n = 21) between start and 12 months. Intra-tumoral cysts were present in 12 OPGs, all showed a decrease of volume during treatment. The relative contrast enhanced volume of NF1 associated OPG (n = 11) showed an significant reduction compared to OPG with a KIAA1549-BRAF fusion (p < 0.01). Three OPGs progressed during treatment, but were not preceded by an increase of relative contrast enhancement. Conclusion Treatment with BVZ of progressive pediatric OPGs leads to a decrease of both total tumor volume and cystic volume for the majority of OPGs with emphasis on the first three months. NF1 and KIAA1549-BRAF fusion related OPGs showed a different (early) treatment effect regarding the tumor enhancing component on MRI, which did not correlate with tumor volume changes. Future research is necessary to further evaluate these findings and its relevance to clinical outcome parameters.
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ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-023-04516-y