Abstract

Background: Detection of glioblastoma progression is important for clinical decision-making on cessation or initiation of therapy, for enrollment in clinical trials, and for response measurement in time and location. The RANO-criteria are considered standard for the timing of progression. To evaluate local treatment, we aim to find the most accurate progression location. We determined the differences in progression free survival (PFS) and in tumor volumes at progression (Vprog) by three definitions of progression. Methods: In a consecutive cohort of 73 patients with newly-diagnosed glioblastoma between 1/1/2012 and 31/12/2013, progression was established according to three definitions. We determined (1) earliest radiological progression (ERP) by retrospective multidisciplinary consensus review using all available imaging and follow-up, (2) clinical practice progression (CPP) from multidisciplinary tumor board conclusions, and (3) progression by the RANO-criteria. Results: ERP was established in 63 (86%), CPP in 64 (88%), RANO progression in 42 (58%). Of the 63 patients who had died, 37 (59%) did with prior RANO-progression, compared to 57 (90%) for both ERP and CPP. The median overall survival was 15.3 months. The median PFS was 8.8 months for ERP, 9.5 months for CPP, and 11.8 months for RANO. The PFS by ERP was shorter than CPP (HR 0.57, 95% CI 0.38–0.84, p = 0.004) and RANO-progression (HR 0.29, 95% CI 0.19–0.43, p < 0.001). The Vprog were significantly smaller for ERP (median 8.8 mL), than for CPP (17 mL) and RANO (22 mL). Conclusion: PFS and Vprog vary considerably between progression definitions. Earliest radiological progression by retrospective consensus review should be considered to accurately localize progression and to address confounding of lead time bias in clinical trial enrollment.

Original languageEnglish
Pages (from-to)591-598
Number of pages8
JournalJournal of Neuro-Oncology
Volume139
Issue number3
DOIs
Publication statusPublished - 1 Sep 2018

Cite this

@article{dab94e9cdb9b4e1596a997dec3133775,
title = "Earliest radiological progression in glioblastoma by multidisciplinary consensus review",
abstract = "Background: Detection of glioblastoma progression is important for clinical decision-making on cessation or initiation of therapy, for enrollment in clinical trials, and for response measurement in time and location. The RANO-criteria are considered standard for the timing of progression. To evaluate local treatment, we aim to find the most accurate progression location. We determined the differences in progression free survival (PFS) and in tumor volumes at progression (Vprog) by three definitions of progression. Methods: In a consecutive cohort of 73 patients with newly-diagnosed glioblastoma between 1/1/2012 and 31/12/2013, progression was established according to three definitions. We determined (1) earliest radiological progression (ERP) by retrospective multidisciplinary consensus review using all available imaging and follow-up, (2) clinical practice progression (CPP) from multidisciplinary tumor board conclusions, and (3) progression by the RANO-criteria. Results: ERP was established in 63 (86{\%}), CPP in 64 (88{\%}), RANO progression in 42 (58{\%}). Of the 63 patients who had died, 37 (59{\%}) did with prior RANO-progression, compared to 57 (90{\%}) for both ERP and CPP. The median overall survival was 15.3 months. The median PFS was 8.8 months for ERP, 9.5 months for CPP, and 11.8 months for RANO. The PFS by ERP was shorter than CPP (HR 0.57, 95{\%} CI 0.38–0.84, p = 0.004) and RANO-progression (HR 0.29, 95{\%} CI 0.19–0.43, p < 0.001). The Vprog were significantly smaller for ERP (median 8.8 mL), than for CPP (17 mL) and RANO (22 mL). Conclusion: PFS and Vprog vary considerably between progression definitions. Earliest radiological progression by retrospective consensus review should be considered to accurately localize progression and to address confounding of lead time bias in clinical trial enrollment.",
keywords = "Glioblastoma, MRI, Progression definition, Progression free survival, RANO",
author = "Eijgelaar, {Roelant S.} and Bruynzeel, {Anna M.E.} and Lagerwaard, {Frank J.} and M{\"u}ller, {Domenique M.J.} and Teunissen, {Freek R.} and Frederik Barkhof and {van Herk}, Marcel and {de Witt Hamer}, {Philip C.} and Witte, {Marnix G.}",
year = "2018",
month = "9",
day = "1",
doi = "10.1007/s11060-018-2896-3",
language = "English",
volume = "139",
pages = "591--598",
journal = "Journal of Neuro-Oncology",
issn = "0167-594X",
publisher = "Kluwer Academic Publishers",
number = "3",

}

Earliest radiological progression in glioblastoma by multidisciplinary consensus review. / Eijgelaar, Roelant S.; Bruynzeel, Anna M.E.; Lagerwaard, Frank J.; Müller, Domenique M.J.; Teunissen, Freek R.; Barkhof, Frederik; van Herk, Marcel; de Witt Hamer, Philip C.; Witte, Marnix G.

In: Journal of Neuro-Oncology, Vol. 139, No. 3, 01.09.2018, p. 591-598.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Earliest radiological progression in glioblastoma by multidisciplinary consensus review

AU - Eijgelaar, Roelant S.

AU - Bruynzeel, Anna M.E.

AU - Lagerwaard, Frank J.

AU - Müller, Domenique M.J.

AU - Teunissen, Freek R.

AU - Barkhof, Frederik

AU - van Herk, Marcel

AU - de Witt Hamer, Philip C.

AU - Witte, Marnix G.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Background: Detection of glioblastoma progression is important for clinical decision-making on cessation or initiation of therapy, for enrollment in clinical trials, and for response measurement in time and location. The RANO-criteria are considered standard for the timing of progression. To evaluate local treatment, we aim to find the most accurate progression location. We determined the differences in progression free survival (PFS) and in tumor volumes at progression (Vprog) by three definitions of progression. Methods: In a consecutive cohort of 73 patients with newly-diagnosed glioblastoma between 1/1/2012 and 31/12/2013, progression was established according to three definitions. We determined (1) earliest radiological progression (ERP) by retrospective multidisciplinary consensus review using all available imaging and follow-up, (2) clinical practice progression (CPP) from multidisciplinary tumor board conclusions, and (3) progression by the RANO-criteria. Results: ERP was established in 63 (86%), CPP in 64 (88%), RANO progression in 42 (58%). Of the 63 patients who had died, 37 (59%) did with prior RANO-progression, compared to 57 (90%) for both ERP and CPP. The median overall survival was 15.3 months. The median PFS was 8.8 months for ERP, 9.5 months for CPP, and 11.8 months for RANO. The PFS by ERP was shorter than CPP (HR 0.57, 95% CI 0.38–0.84, p = 0.004) and RANO-progression (HR 0.29, 95% CI 0.19–0.43, p < 0.001). The Vprog were significantly smaller for ERP (median 8.8 mL), than for CPP (17 mL) and RANO (22 mL). Conclusion: PFS and Vprog vary considerably between progression definitions. Earliest radiological progression by retrospective consensus review should be considered to accurately localize progression and to address confounding of lead time bias in clinical trial enrollment.

AB - Background: Detection of glioblastoma progression is important for clinical decision-making on cessation or initiation of therapy, for enrollment in clinical trials, and for response measurement in time and location. The RANO-criteria are considered standard for the timing of progression. To evaluate local treatment, we aim to find the most accurate progression location. We determined the differences in progression free survival (PFS) and in tumor volumes at progression (Vprog) by three definitions of progression. Methods: In a consecutive cohort of 73 patients with newly-diagnosed glioblastoma between 1/1/2012 and 31/12/2013, progression was established according to three definitions. We determined (1) earliest radiological progression (ERP) by retrospective multidisciplinary consensus review using all available imaging and follow-up, (2) clinical practice progression (CPP) from multidisciplinary tumor board conclusions, and (3) progression by the RANO-criteria. Results: ERP was established in 63 (86%), CPP in 64 (88%), RANO progression in 42 (58%). Of the 63 patients who had died, 37 (59%) did with prior RANO-progression, compared to 57 (90%) for both ERP and CPP. The median overall survival was 15.3 months. The median PFS was 8.8 months for ERP, 9.5 months for CPP, and 11.8 months for RANO. The PFS by ERP was shorter than CPP (HR 0.57, 95% CI 0.38–0.84, p = 0.004) and RANO-progression (HR 0.29, 95% CI 0.19–0.43, p < 0.001). The Vprog were significantly smaller for ERP (median 8.8 mL), than for CPP (17 mL) and RANO (22 mL). Conclusion: PFS and Vprog vary considerably between progression definitions. Earliest radiological progression by retrospective consensus review should be considered to accurately localize progression and to address confounding of lead time bias in clinical trial enrollment.

KW - Glioblastoma

KW - MRI

KW - Progression definition

KW - Progression free survival

KW - RANO

UR - http://www.scopus.com/inward/record.url?scp=85047126480&partnerID=8YFLogxK

U2 - 10.1007/s11060-018-2896-3

DO - 10.1007/s11060-018-2896-3

M3 - Article

VL - 139

SP - 591

EP - 598

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

SN - 0167-594X

IS - 3

ER -