RTHP-04. TUMOR RECURRENCE OR RADIATION NECROSIS FOLLOWING CHEMORADIATION IN PATIENTS WITH GLIOBLASTOMA: DOES PATHOLOGY PREDICT OUTCOMES?. (5th November 2018)

• Record Type: Journal Article
• Authors: Patrizz, Anthony; Choi, Phil; Yan, Yuanqing; Zorofchian, Sohiel; Ballister, Leomar; Esquenazi, Yoshua
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 6
• Page Start: vi226
• Page End: vi226
• Publication Date: 2018-11-05
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy148.936
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: Chemoradiation following surgical resection of glioblastoma has improved overall survival (OS). Unfortunately, all patients develop progression of the disease, typically characterized as worsening radiographic appearance. Radiological imaging is limited in differentiating tumor progression from radiation-induced necrosis; therefore, re-resection is often needed to remove the abnormal tissue. There is little and contradictory data assessing the relationship between pathological evaluation (active tumor vs. radiation necrosis) and clinical outcomes. We performed a large retrospective study to analyze the prognostic value and clinical significance of the pathology evaluation following re-resection in patients with presumed tumor progression. Clinical, radiographic and pathological information was compiled from 675 patients with GBM from the Memorial Hermann Health Care System between 2010 and 2017. Second surgery was performed in 121 (18%) patients (mean age=56, median KPS=80) with presumed progression following chemoradiation. According to the pathology report following second surgery patients were classified into 2 groups (1: recurrent tumor- # of patients = 91 and 2: radiation necrosis # of patients = 30). A Kaplan-Meier survival analysis was performed comparing the OS of each group. No statistically significant differences in OS from initial diagnosis (median OS: active tumor 22.6 mo, radiation necrosis 21.3 mo, p=0.4) and suspected recurrence (median OS: active tumor 12.7 mo, radiation necrosis 13.7 mo, p=0.3) were found between the groups. The current study suggests that histopathologic findings following chemoradiation cannot predict outcomes. These findings are important and should be considered to guide treatment strategies and clinical trial endpoints.