36Glioblastoma Multiforme (GBM) is a rapidly dividing tumour associated with a poor prognosis.1,2 The current standard of care for newly diagnosed GBM is surgical resection followed by radiotherapy with concurrent temozolomide (RT/TMZ) and then maintenance temozolomide for at least six months. Contrast-based imaging studies, computerized tomography (CT) or magnetic resonance (MR), may reveal increased contrast-enhancement and peritumoural edema following radiotherapy, with or without the use of concurrent temozolomide. Although in some cases these changes reflect tumour growth due to the treatment resistant nature of GBM , we ABSTRACT: Purpose: Pseudoprogression (psPD) is now recognised following radiotherapy with concurrent temozolomide (RT/TMZ) for glioblastoma multiforme (GBM). The aim of this study was to determine the incidence of psPD following RT/TMZ and the effect of psPD on prognosis. Materials/Methods: All patients receiving RT/TMZ for newly diagnosed GBM were identified from a prospective database. Clinical and radiographic data were retrospectively reviewed. Early progression was defined as radiological progression (RECIST criteria) during or within eight weeks of completing RT/TMZ. Pseudoprogression was defined as early progression with subsequent disease stabilization, without salvage therapy, for at least six months from completion of RT/TMZ. The primary outcome was overall survival (Kaplan-Meier) and log rank analysis was used to compare groups. Results: Out of 111 patients analyzed, 104 were evaluable for radiological response. Median age was 58 years and median follow-up 55 weeks. Early progression was confirmed in 26% and within this group 32% had psPD. Median survival for the whole cohort was 56.7 weeks [95% CI (51.0, 71.3)]. Median survival for patients with psPD was significantly higher than for patients with true early progression (124.9 weeks versus 36.0 weeks, p=0.0286). Conclusions: Approximately one third of patients with early progression were found to have psPD which was associated with a favourable prognosis. Maintenance TMZ should not be abandoned on the basis of seemingly discouraging imaging features identified within the first three months after RT/TMZ. RÉSUMÉ: Pseudoprogression après la chimioradiothérapie dans le traitement du glioblastome multiforme. Objectif : La pseudoprogression (psPD), qui survient après le traitement par radiothérapie associée à l'administration de témozolomide (RT/TMZ) pour traiter le glioblastome multiforme (GBM), est maintenant bien connue. Le but de cette étude était de déterminer l'incidence de la psPD après le traitement par la RT/TMZ et ses conséquences sur le pronostic. Matériel et méthodes : Tous les patients traités par RT/TMZ pour un GBM nouvellement diagnostiqué ont été identifiés dans une banque de données prospective. Les données cliniques et radiologiques ont été révisées rétrospectivement. Une progression précoce était définie comme une progression radiologique (critères RECIST) pendant ou au cours des 8 semaines suivant la fin du traitem...
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