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Proton magnetic resonance spectroscopy predicts radiotherapy response and time-to-progression in high-grade gliomas after surgery

摘要Background Reliable early prediction response to therapy and time-to-progression (TTP) remain an important goal of high-grade gliomas (HGGs) research.Proton magnetic resonance spectroscopy (1H-MRS) has been applied with variable success in clinical application,and we hypothesize that 1H-MRS in predictive value should perform well as a marker of TTP in patients treated with radiotherapy (RT) after surgery.Methods 1H-MRS was performed before surgery on 25 patients who had undergone resection of HGGs; then the ratios of lipid/creatine (Lip/Cr) and myo-inositol/creatine (ml/Cr) were determined in the solid tumor.RT response was classified as follows:complete resolution (CR),partial response (PR),stable disease (SD),and progressive disease (PD) by comparison of pre-treatment and post-radiotherapy scans.TTP was defined at the time to radiographic progression by MacDonald criteria.Correlation was evaluated between the ratios of Lip/Cr,ml/Cr and treatment response,TTP.The chi-square test and Pearson correlation test were used for data analyses.Results Multivariate analysis revealed that the prognostic value of spectroscopic variables was independent of age,sex,WHO histologic grade,extent of surgery,and Karnofsky score (KPS).The correlation between the ratios of lipid/Cr and TTP was significant (r=0.894,P=0.000),and between the ratios of ml/Cr and TTP was also significant (r=0.891,P=0.000).As predicted,RT response correlated significantly with TTP (r=0.59,P=0.002):median TTP was 49.9 days for patients with PD compared with 202.7 days for SD,208.0 days for PR,and 234.5 days for CR.Conclusion The ratios of Lip/Cr and ml/Cr of the solid tumor region before surgery could provide important information in predicting RT response and TTP in patients with HGGs treated by radiation alone after surgery.

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作者单位 Department of Radiology, Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, Henan 450008, China [1] Department of Neurosurgery , Beijing Tiantan Hospital,Capital Medical University, Beijing 100050, China [2] Department of Neuroradiology,Beijing Tiantan Hospital,Capital Medical University, Beijing 100050, China [3] Institute of Automation Chinese Academy of Sciences, Beijing100190, China [4]
栏目名称 ORIGINAL ARTICLES
DOI 10.3760/cma.j.issn.0366-6999.2012.24.003
发布时间 2013-02-22
基金项目
This study was supported by grants of the National Key Project of Science and Technology Supporting Programs of China the National Natural Science Foundation of China the International Cooperation Project of Henan Science and Technology Supporting Programs of China special funding of the Henan Health Science and Technology Innovation Talent Project
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中华医学杂志(英文版)

中华医学杂志(英文版)

2012年125卷24期

4334-4337页

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