Predicting the outcome of grade II glioma treated with temozolomide using proton magnetic resonance spectroscopy
Identifieur interne : 000D24 ( Ncbi/Curation ); précédent : 000D23; suivant : 000D25Predicting the outcome of grade II glioma treated with temozolomide using proton magnetic resonance spectroscopy
Auteurs : R. Guillevin [France] ; C. Menuel [France] ; S. Taillibert [France] ; L. Capelle [France] ; R. Costalat [France] ; L. Abud [France] ; C. Habas [France] ; G. De Marco [France] ; K. Hoang-Xuan [France] ; J. Chiras [France] ; J-N Vallée [France]Source :
- British Journal of Cancer [ 0007-0920 ] ; 2011.
Abstract
This study was designed to evaluate proton magnetic resonance spectroscopy (1H-MRS) for monitoring the WHO grade II glioma (low-grade glioma (LGG)) treated with temozolomide (TMZ).
This prospective study included adult patients with progressive LGG that was confirmed by magnetic resonance imaging (MRI). Temozolomide was administered at every 28 days. Response to TMZ was evaluated by monthly MRI examinations that included MRI with volumetric calculations and 1H-MRS for assessing Cho/Cr and Cho/NAA ratios. Univariate, multivariate and receiver-operating characteristic statistical analyses were performed on the results.
A total of 21 LGGs from 31 patients were included in the study, and followed for at least
The 1H-MRS profile changes more widely and rapidly than tumour volume during the response and relapse phases, and represents an early predictive factor of outcome over 14 months of follow-up. Thus, 1H-MRS may be a promising, non-invasive tool for predicting and monitoring the clinical response to TMZ.
Url:
DOI: 10.1038/bjc.2011.174
PubMed: 21610707
PubMed Central: 3111204
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<author><name sortKey="Hoang Xuan, K" sort="Hoang Xuan, K" uniqKey="Hoang Xuan K" first="K" last="Hoang-Xuan">K. Hoang-Xuan</name>
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<author><name sortKey="Menuel, C" sort="Menuel, C" uniqKey="Menuel C" first="C" last="Menuel">C. Menuel</name>
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<author><name sortKey="Capelle, L" sort="Capelle, L" uniqKey="Capelle L" first="L" last="Capelle">L. Capelle</name>
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<author><name sortKey="Costalat, R" sort="Costalat, R" uniqKey="Costalat R" first="R" last="Costalat">R. Costalat</name>
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<country xml:lang="fr">France</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Abud, L" sort="Abud, L" uniqKey="Abud L" first="L" last="Abud">L. Abud</name>
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, 75013 Paris,<country>France</country>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Habas, C" sort="Habas, C" uniqKey="Habas C" first="C" last="Habas">C. Habas</name>
<affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Department of Neuroradiology, XV-XX Hospital</institution>
, 75571 Paris,<country>France</country>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="De Marco, G" sort="De Marco, G" uniqKey="De Marco G" first="G" last="De Marco">G. De Marco</name>
<affiliation wicri:level="1"><nlm:aff id="aff7"><institution>Laboratoire Contrôle Moteur et Mouvement, UFR STAPS Paris X</institution>
, 200 Avenue de la République, 92001 Nanterre,<country>France</country>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="Hoang Xuan, K" sort="Hoang Xuan, K" uniqKey="Hoang Xuan K" first="K" last="Hoang-Xuan">K. Hoang-Xuan</name>
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, 75013 Paris,<country>France</country>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="Chiras, J" sort="Chiras, J" uniqKey="Chiras J" first="J" last="Chiras">J. Chiras</name>
<affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Department of Neuro-oncology, Pitié Salpêtrière Hospital</institution>
, 75013 Paris,<country>France</country>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="Vallee, J N" sort="Vallee, J N" uniqKey="Vallee J" first="J-N" last="Vallée">J-N Vallée</name>
<affiliation wicri:level="1"><nlm:aff id="aff8"><institution>Department of Neuroradiology, Amiens University Medical Center, University of Picardie Jules Vernes</institution>
, 80054 Amiens,<country>France</country>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<series><title level="j">British Journal of Cancer</title>
<idno type="ISSN">0007-0920</idno>
<idno type="eISSN">1532-1827</idno>
<imprint><date when="2011">2011</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><sec><title>Background:</title>
<p>This study was designed to evaluate proton magnetic resonance spectroscopy (<sup>1</sup>
H-MRS) for monitoring the WHO grade II glioma (low-grade glioma (LGG)) treated with temozolomide (TMZ).</p>
</sec>
<sec><title>Methods:</title>
<p>This prospective study included adult patients with progressive LGG that was confirmed by magnetic resonance imaging (MRI). Temozolomide was administered at every 28 days. Response to TMZ was evaluated by monthly MRI examinations that included MRI with volumetric calculations and <sup>1</sup>
H-MRS for assessing Cho/Cr and Cho/NAA ratios. Univariate, multivariate and receiver-operating characteristic statistical analyses were performed on the results.</p>
</sec>
<sec><title>Results:</title>
<p>A total of 21 LGGs from 31 patients were included in the study, and followed for at least <italic>n</italic>
=14 months during treatment. A total of 18 (86%) patients experienced a decrease in tumour volume with a greater decrease of metabolic ratios. Subsequently, five (28%) of these tumours resumed growth despite the continuation of TMZ administration with an earlier increase of metabolic ratios of 2 months. Three (14%) patients did not show any volume or metabolic change. The evolutions of the metabolic ratios, mean(<italic>Cho</italic>
/<italic>Cr</italic>
)<sub><italic>n</italic>
</sub>
and mean(<italic>Cho</italic>
/<italic>NAA</italic>
)<sub><italic>n</italic>
</sub>
, were significantly correlated over time (Spearman <italic>ρ</italic>
=+0.95) and followed a logarithmic regression (<italic>P</italic>
>0.001). The evolutions over time of metabolic ratios, mean(<italic>Cho</italic>
/<italic>Cr</italic>
)<sub><italic>n</italic>
</sub>
and mean(<italic>Cho</italic>
/<italic>NAA</italic>
)<sub><italic>n</italic>
</sub>
, were significantly correlated with the evolution of the mean relative decrease of tumour volume, mean(Δ<italic>V</italic>
<sub><italic>n</italic>
</sub>
/<italic>V</italic>
<sub><italic>o</italic>
</sub>
), according to a linear regression (<italic>P</italic>
<0.001) in the ‘response/no relapse' patient group, and with the evolution of the mean tumour volume (mean<italic>V</italic>
<sub><italic>n</italic>
</sub>
), according to an exponential regression (<italic>P</italic>
<0.001) in the ‘response/relapse' patient group. The mean relative decrease of metabolic ratio, mean(Δ(<italic>Cho</italic>
/<italic>Cr</italic>
)<sub><italic>n</italic>
</sub>
/(<italic>Cho</italic>
/<italic>Cr</italic>
)<sub><italic>o</italic>
</sub>
), at <italic>n</italic>
=3 months was predictive of tumour response over the 14 months of follow-up. The mean relative change between metabolic ratios, mean((<italic>Cho</italic>
/<italic>NAA</italic>
)<sub><italic>n</italic>
</sub>
−(<italic>Cho</italic>
/<italic>Cr</italic>
)<sub><italic>n</italic>
</sub>
)/(<italic>Cho</italic>
/<italic>NAA</italic>
)<sub><italic>n</italic>
</sub>
, at <italic>n</italic>
=4 months was predictive of tumour relapse with a significant cutoff of 0.046, a sensitivity of 60% and a specificity of 100% (<italic>P</italic>
=0.004).</p>
</sec>
<sec><title>Conclusions:</title>
<p>The <sup>1</sup>
H-MRS profile changes more widely and rapidly than tumour volume during the response and relapse phases, and represents an early predictive factor of outcome over 14 months of follow-up. Thus, <sup>1</sup>
H-MRS may be a promising, non-invasive tool for predicting and monitoring the clinical response to TMZ.</p>
</sec>
</div>
</front>
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