TY - JOUR
T1 - Pseudoprogression, radionecrosis, inflammation or true tumor progression? challenges associated with glioblastoma response assessment in an evolving therapeutic landscape
AU - Ellingson, Benjamin M.
AU - Chung, Caroline
AU - Pope, Whitney B.
AU - Boxerman, Jerrold L.
AU - Kaufmann, Timothy J.
N1 - Publisher Copyright:
© 2017, Springer Science+Business Media New York.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - The wide variety of treatment options that exist for glioblastoma, including surgery, ionizing radiation, anti-neoplastic chemotherapies, anti-angiogenic therapies, and active or passive immunotherapies, all may alter aspects of vascular permeability within the tumor and/or normal parenchyma. These alterations manifest as changes in the degree of contrast enhancement or T2-weighted signal hyperintensity on standard anatomic MRI scans, posing a potential challenge for accurate radiographic response assessment for identifying anti-tumor effects. The current review highlights the challenges that remain in differentiating true disease progression from changes due to radiation therapy, including pseudoprogression and radionecrosis, as well as immune or inflammatory changes that may occur as either an undesired result of cytotoxic therapy or as a desired consequence of immunotherapies.
AB - The wide variety of treatment options that exist for glioblastoma, including surgery, ionizing radiation, anti-neoplastic chemotherapies, anti-angiogenic therapies, and active or passive immunotherapies, all may alter aspects of vascular permeability within the tumor and/or normal parenchyma. These alterations manifest as changes in the degree of contrast enhancement or T2-weighted signal hyperintensity on standard anatomic MRI scans, posing a potential challenge for accurate radiographic response assessment for identifying anti-tumor effects. The current review highlights the challenges that remain in differentiating true disease progression from changes due to radiation therapy, including pseudoprogression and radionecrosis, as well as immune or inflammatory changes that may occur as either an undesired result of cytotoxic therapy or as a desired consequence of immunotherapies.
KW - Glioblastoma
KW - Imaging
KW - Pseudoprogression
KW - Radiation necrosis
UR - http://www.scopus.com/inward/record.url?scp=85017170466&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85017170466&partnerID=8YFLogxK
U2 - 10.1007/s11060-017-2375-2
DO - 10.1007/s11060-017-2375-2
M3 - Review article
C2 - 28382534
AN - SCOPUS:85017170466
SN - 0167-594X
VL - 134
SP - 495
EP - 504
JO - Journal of neuro-oncology
JF - Journal of neuro-oncology
IS - 3
ER -