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@ARTICLE{Ellingson:141668,
author = {B. M. Ellingson and L. E. Abrey and J. Garcia and O. Chinot
and W. Wick$^*$ and F. Saran and R. Nishikawa and R.
Henriksson and W. P. Mason and R. J. Harris and K. Leu and
D. C. Woodworth and A. Mehta and C. Raymond and A. Chakhoyan
and W. B. Pope and T. F. Cloughesy},
title = {{P}ost-chemoradiation volumetric response predicts survival
in newly diagnosed glioblastoma treated with radiation,
temozolomide, and bevacizumab or placebo.},
journal = {Neuro-Oncology},
volume = {20},
number = {11},
issn = {1523-5866},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {DKFZ-2018-01939},
pages = {1525 - 1535},
year = {2018},
abstract = {In the current study we used contrast-enhanced T1
subtraction maps to test whether early changes in enhancing
tumor volume are prognostic for overall survival (OS) in
newly diagnosed glioblastoma (GBM) patients treated with
chemoradiation with or without bevacizumab (BV).Seven
hundred ninety-eight patients (404 BV and 394 placebo) with
newly diagnosed GBM in the AVAglio trial (NCT00943826) had
baseline MRI scans available, while 337 BV-treated and 269
placebo-treated patients had >4 MRI scans for response
evaluation. The volume of contrast-enhancing tumor was
quantified and used for subsequent analyses.A decrease in
tumor volume during chemoradiation was associated with a
longer OS in the placebo group (hazard ratio [HR] = 1.578, P
< 0.0001) but not BV-treated group (HR = 1.135, P = 0.4889).
Results showed a higher OS in patients on the placebo arm
with a sustained decrease in tumor volume using a
post-chemoradiation baseline (HR = 1.692, P = 0.0005), and a
trend toward longer OS was seen in BV-treated patients (HR =
1.264, P = 0.0724). Multivariable Cox regression confirmed
that sustained response or stable disease was prognostic for
OS (HR = 0.7509, P = 0.0127) when accounting for age (P =
0.0002), KPS (P = 0.1516), postsurgical tumor volume (P <
0.0001), O6-methylguanine-DNA methyltransferase status (P <
0.0001), and treatment type (P = 0.7637) using the
post-chemoradiation baseline.The post-chemoradiation
timepoint is a better baseline for evaluating efficacy in
newly diagnosed GBM. Early progression during the
maintenance phase is consequential in predicting OS,
supporting the use of progression-free survival rates as a
meaningful surrogate for GBM.},
cin = {G370},
ddc = {610},
cid = {I:(DE-He78)G370-20160331},
pnm = {317 - Translational cancer research (POF3-317)},
pid = {G:(DE-HGF)POF3-317},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:29897562},
pmc = {pmc:PMC6178278},
doi = {10.1093/neuonc/noy064},
url = {https://inrepo02.dkfz.de/record/141668},
}