Geometrical Measures Obtained from Pretreatment Postcontrast T1 Weighted MRIs Predict Survival Benefits from Bevacizumab in Glioblastoma Patients
Molina García, David (Universidad de Castilla-La Mancha)
Pérez Beteta, Julián (Universidad de Castilla-La Mancha)
Martínez González, Alicia (Universidad de Castilla-La Mancha)
Sepúlveda, Juan M. (Hospital Universitario 12 de Octubre (Madrid))
Peralta, Sergi (Hospital Universitari Sant Joan de Reus (Tarragona))
Gil-Gil, Miguel (Institut Català d'Oncologia)
Reynes, Gaspar (Hospital Universitari i Politècnic La Fe (València))
Herrero, Ana (Hospital Universitario Miguel Servet (Saragossa))
de las Peñas, Ramon (Consorci Hospitalari Provincial de Castelló)
Luque, Raquel (Hospital Universitario Virgen de las Nieves (Granada))
Capellades, Jaume (Hospital del Mar (Barcelona, Catalunya))
Balañá, Carmen (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pérez García, Víctor M. (Universidad de Castilla-La Mancha)

Fecha:	2016
Resumen:	Background: Antiangiogenic therapies for glioblastoma (GBM) such as bevacizumab (BVZ), have been unable to extend survival in large patient cohorts. However, a subset of patients having angiogenesis-dependent tumors might benefit from these therapies. Currently, there are no biomarkers allowing to discriminate responders from non-responders before the start of the therapy. Methods: 40 patients from the randomized GENOM009 study complied the inclusion criteria (quality of images, clinical data available). Of those, 23 patients received first line temozolomide (TMZ) for eight weeks and then concomitant radiotherapy and TMZ. 17 patients received BVZ+TMZ for seven weeks and then added radiotherapy to the treatment. Clinical variables were collected, tumors segmented and several geometrical measures computed including: Contrast enhancing (CE), necrotic, and total volumes; equivalent spherical CE width; several geometric measures of the CE 'rim' geometry and a set of image texture measures. The significance of the results was studied using Kaplan-Meier and Cox proportional hazards analysis. Correlations were assessed using Spearman correlation coefficients. Results: Kaplan-Meier and Cox proportional hazards analysis showed that total, CE and inner volume (p = 0. 019, HR = 4. 258) and geometric heterogeneity of the CE areas (p = 0. 011, HR = 3. 931) were significant parameters identifying response to BVZ. The group of patients with either regular CE areas (small geometric heterogeneity, median difference survival 15. 88 months, p = 0. 011) or those with small necrotic volume (median survival difference 14. 50 months, p = 0. 047) benefited substantially from BVZ. Conclusion: Imaging biomarkers related to the irregularity of contrast enhancing areas and the necrotic volume were able to discriminate GBM patients with a substantial survival benefit from BVZ. A prospective study is needed to validate our results.
Ayudas:	Ministerio de Economía y Competitividad FEDER/MTM2015-71200-R
Nota:	Altres ajuts: James S. Mc. Donnell Foundation 21st Century Science Initiative in Mathematical and Complex Systems Approaches for Brain Cancer: Planning Grant 220020420 i Collaborative Award 220020450
Nota:	Altres ajuts: PEII-2014-031-P
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Cervell ; Tumors ; Glioblastoma ; Bevacizumab
Publicado en:	PloS one, Vol. 11 Núm. 8 (August 2016) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0161484
PMID: 27557121

16 p, 911.4 KB

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