Pseudoprogression in children, adolescents and young adults with non-brainstem high grade glioma and diffuse intrinsic pontine glioma

• Verfasst von: Carceller, Fernando [VerfasserIn]
• Verfasst von: Jones, David T. W. [VerfasserIn]
• Verfasst von: Hovestadt, Volker [VerfasserIn]
• Verfasst von: Pfister, Stefan [VerfasserIn]
• Titel: Pseudoprogression in children, adolescents and young adults with non-brainstem high grade glioma and diffuse intrinsic pontine glioma
• Verf.angabe: Fernando Carceller, Lucy A. Fowkes, Komel Khabra, Lucas Moreno, Frank Saran, Anna Burford, Alan Mackay, David T.W. Jones, Volker Hovestadt, Lynley V. Marshall, Sucheta Vaidya, Henry Mandeville, Neil Jerome, Leslie R. Bridges, Ross Laxton, Safa Al-Sarraj, Stefan M. Pfister, Martin O. Leach, Andrew D.J. Pearson, Chris Jones, Dow-Mu Koh, Stergios Zacharoulis
• E-Jahr: 2016
• Jahr: August 2016
• Umfang: 23 S.
• Fussnoten: Gesehen am 21.11.2018
• Titel Quelle: Enthalten in: Journal of neuro-oncology
• Ort Quelle: Dordrecht [u.a.] : Springer Science + Business Media B.V, 1983
• Jahr Quelle: 2016
• Band/Heft Quelle: 129(2016), 1, Seite 109-121
• ISSN Quelle: 1573-7373
• DOI: doi:10.1007/s11060-016-2151-8
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Brain tumors
• Sach-SW: Childhood
• Sach-SW: Children
• Sach-SW: Diffuse intrinsic pontine glioma
• Sach-SW: High grade glioma
• Sach-SW: Pseudoprogression
• K10plus-PPN: 1583919570

Abstract

Pseudoprogression (PsP) is a treatment-related phenomenon which hinders response interpretation. Its prevalence and clinical impact have not been evaluated in children/adolescents. We assessed the characteristics, risk factors and prognosis of PsP in children/adolescents and young-adults diagnosed with non-brainstem high grade gliomas (HGG) and diffuse intrinsic pontine gliomas (DIPG). Patients aged 1-21 years diagnosed with HGG or DIPG between 1995 and 2012 who had completed radiotherapy were eligible. PsP was assessed according to study-specific criteria and correlated with first-line treatment, molecular biomarkers and survival. Ninety-one patients (47 HGG, 44 DIPG) were evaluable. Median age: 10 years (range, 2-20). Eleven episodes of PsP were observed in 10 patients (4 HGG, 6 DIPG). Rates of PsP: 8.5 % (HGG); 13.6 % (DIPG). Two episodes of PsP were based on clinical findings alone; nine episodes had concurrent radiological changes: increased size of lesions (n = 5), new focal enhancement (n = 4). Temozolomide, MGMT methylation or H3F3A mutations were not found to be associated with increased occurrence of PsP. For HGG, 1-year progression-free survival (PFS) was 41.9 % no-PsP versus 100 % PsP (p = 0.041); differences in 1-year overall survival (OS) were not significant. For DIPG, differences in 1-year PFS and OS were not statistically significant. Hazard ratio (95 %CI) of PsP for OS was 0.551 (0.168-1.803; p = 0.325) in HGG; and 0.308 (0.107-0.882; p = 0.028) in DIPG. PsP occurred in both pediatric HGG and DIPG patients at a comparable rate to adult HGG. PsP was associated with improved 1-yr PFS in HGG patients. PsP had a protective effect upon OS in DIPG patients.