贝伐单抗对难治性脑膜瘤的影响:三维体积生长率与神经肿瘤学标准中的反应评估。

IF 3.7 Q1 CLINICAL NEUROLOGY Neuro-oncology advances Pub Date : 2024-08-13 eCollection Date: 2024-01-01 DOI:10.1093/noajnl/vdae128
Sara Faye Borenstein, Ruth Eliahou, Alexandra Amiel, Alisa Talianski, Jonathan Ofer, Shaked Even-Haim, Andrew Kanner, Yosef Laviv, Dror Limon, Tali Siegal, Shlomit Yust-Katz
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引用次数: 0

摘要

背景:脑膜瘤是中枢神经系统最常见的原发性肿瘤:脑膜瘤是中枢神经系统最常见的原发性肿瘤。约15%-20%的脑膜瘤具有侵袭性,尽管接受了常规治疗,仍有复发和进展的趋势。回顾性研究发现,贝伐单抗对治疗难治性脑膜瘤有效。神经肿瘤学反应评估(RANO)标准被广泛用于评估治疗效果。最近的研究表明,三维体积生长率(3DVGR)可能对形状不规则的肿瘤更为准确。本研究旨在比较这些方法:20名难治性脑膜瘤患者接受了贝伐单抗治疗。两名放射科医生分别使用 PACS 和 BRAIN LAB iPLAN 软件,在开始治疗前后使用 RANO 标准和 3DVGR 对肿瘤进行测量,并对结果进行比较:结果:共有 46 个病灶被纳入最终分析。两种评估方法均显示贝伐单抗有效。根据 RANO 标准,6 个月无进展生存率为 47%。根据 3DVGR,所有病变的特征都是在开始治疗后体积缩小或生长稳定。90%的病灶的3DVGR下降了50%或更多。有几名患者的 RANO 标准和 3DVGR 不一致:尽管 RANO 标准已被广泛接受用于评估脑膜瘤的治疗反应,但 3DVGR 似乎能对形状不规则的肿瘤进行更精确的测量。这项研究的结果为贝伐单抗治疗难治性脑膜瘤提供了重要证据。
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Effect of bevacizumab on refractory meningiomas: 3D volumetric growth rate versus response assessment in neuro-oncology criteria.

Background: Meningiomas are the most common primary tumor in the central nervous system. About 15%-20% are aggressive and tend to recur and progress despite conventional treatment. Bevacizumab has been found to be effective in the treatment of refractory meningiomas in retrospective studies. The Response Assessment in Neuro-Oncology (RANO) criteria are widely used to assess the effect of treatment. Recent studies suggest that the 3D volumetric growth rate (3DVGR) may be more accurate for irregularly shaped tumors. The aim of this study was to compare these approaches.

Methods: Twenty patients with refractory meningiomas were treated with bevacizumab. Tumors were measured using the RANO criteria and 3DVGR before and after initiation of treatment by 2 radiologists using PACS and BRAIN LAB iPLAN software, respectively, findings were compared.

Results: A total of 46 lesions were included in the final analysis. Bevacizumab was shown to be effective by both assessment methods. According to RANO criteria, the rate of progression-free survival at 6 months was 47%. According to 3DVGR, all lesions were characterized by either a decrease in volume or stable growth after treatment initiation. A decrease in 3DVGR of 50% or more was found in 90% of lesions. In several patients, there were discordances between RANO criteria and 3DVGR.

Conclusions: Although RANO criteria are widely accepted for evaluation of response to treatment of meningiomas, 3DVGR seems to generate more precise measurements of irregularly shaped tumors. The results of this study offer important evidence that bevacizumab may be beneficial in treating refractory meningiomas.

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