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P10.14 Long-term impact of Temozolomide on 1p19q codeleted oligodendrogliomas growth kinetics

机译:P10.14替莫唑胺对1p19q加码的少突神经胶质瘤生长动力学的长期影响

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摘要

BACKGROUND: Growth kinetics studies have shown that most 1p/19q co-deleted low-grade oligodendrogliomas (OII) present an initial volume decrease when treated with upfront temozolomide (TMZ). However, the duration of this volumetric response has not been precisely studied. Herein, we evaluated the long-term impact of upfront TMZ on OII growth kinetics. MATERIAL AND METHODS: The growth kinetics of 36 OII was evaluated on serial magnetic resonance images before (n=20), during and after treatment (n=36) with upfront TMZ. >Results: Median follow-up was 6.5 years (range: 2.07-11.56), median age at TMZ onset was 45.2 years (range: 2.07-11.56) and the median number of TMZ cycles was 18 (range: 2-29). After TMZ onset, all but two patients (94.4%) presented a volume decrease that lasted for a median duration of 17.9 months (range: 2.7-103.9). In 12 patients volume regrowth occurred during TMZ treatment and in 22 patients after TMZ discontinuation. In patients in whom TMZ was discontinued in the absence of progression, a prolonged (>2 years) ongoing volume decrease was observed in 9 patients. However, at 3 and 5 years after TMZ onset, an ongoing volume decrease was only observed in 4 patients (11%) and 2 patients (5.9 %). In contrast to the 17.9 months median duration of volumetric response the median progression free survival as evaluated by the treating neuro-oncologists was 45.7 months. >Conclusions: Long-term analysis of growth kinetics shows that in OII, upfront TMZ results in a prolonged volumetric response in only a limited number of patients and that the impact of this chemotherapy regimen may be overestimated in the absence of precise volumetric analysis.
机译:背景:生长动力学研究表明,大多数的1p / 19q共删除的低级少突神经胶质瘤(OII)在使用前替莫唑胺(TMZ)治疗时会出现初始体积减少。但是,尚未对此体积反应的持续时间进行精确研究。在这里,我们评估了前期TMZ对OII生长动力学的长期影响。材料与方法:在连续的磁共振图像上,使用前期TMZ治疗前(n = 20),治疗期间和治疗后(n = 36),对36 OII的生长动力学进行了评估。 >结果:中位随访时间为6.5年(范围:2.07-11.56),TMZ发作中位年龄为45.2年(范围:2.07-11.56),TMZ周期中位数为18(范围) :2-29)。 TMZ发作后,除两名患者外(94.4%),所有患者均出现体积减少,持续中位持续时间为17.9个月(范围:2.7-103.9)。在TMZ治疗期间有12名患者发生了体积再生长,在TMZ停用后有22例患者出现了再生长。在没有进展的情况下中止TMZ的患者中,有9名患者观察到持续(> 2年)持续的容量减少。然而,在TMZ发作后3年和5年,仅4例患者(11%)和2例患者(5.9%)观察到持续的血容量减少。与17.9个月的中位体积反应持续时间相比,经治疗的神经肿瘤学家评估的中位无进展生存期为45.7个月。 >结论:生长动力学的长期分析表明,在OII中,前期TMZ仅在少数患者中导致体积反应延长,如果没有,则可能会高估这种化疗方案的影响精确的体积分析。

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