Ongoing and prolonged response in adult low-grade gliomas treated with radiotherapy

• Published in: Journal of neuro-oncology Vol. 115; no. 2; pp. 261 - 265
• Main Authors: Ducray, F., Kaloshi, G., Houillier, C., Idbaih, A., Ribba, B., Psimaras, D., Marie, Y., Boisselier, B., Alentorn, A., Dainese, L., Navarro, S., Mokhtari, K., Sanson, M., Hoang-Xuan, K., Delattre, Jean-Yves
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-11-2013; Springer Nature B.V; Springer Verlag
• Subjects: Adolescent; Adult; Aged; Brain Neoplasms - mortality; Brain Neoplasms - pathology; Brain Neoplasms - radiotherapy; Clinical Study; Computer Science; Disease Progression; Female; Follow-Up Studies; Glioma - mortality; Glioma - pathology; Glioma - radiotherapy; Humans; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Modeling and Simulation; Neoplasm Grading; Neurology; Oncology; Retrospective Studies; Survival Rate; Time Factors; Treatment Outcome; Young Adult; 1p19q codeletion; Radiotherapy; TP53; Mean tumor diameter; IDH1; Low-grade glioma
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1007/s11060-013-1224-1

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.