高级别胶质瘤放射及化学治疗后假性进展

Pseudoprogression after Radiochemotherapy for High-grade Glioma

目的探讨高级别胶质瘤患者放射、化学治疗后假性进展的临床特点、诊断与处理。方法分析2008年6月2009年6月接受综合治疗的31例高级别胶质瘤患者临床资料,对假性进展的患者进行回顾分析,按照实体瘤疗效评判标准应用磁共振进行疗效评价。结果 31例术后病理诊断为高级别胶质瘤的患者,替莫唑胺(TMZ)同期放射、化学治疗后维持TMZ辅助化学疗法,放射治疗后早期发生假性进展4例(14%)。结论对于TMZ同期放射、化学治疗后早期出现的影像学疑似进展,不要急于下结论,了解假性进展的临床特点,结合功能影像学检查可能会有助于临床医生的判断与处理。

Objective To discuss the clinical feature,diagnosis,and management of pseudoprogression after radiochemotherapy of high-grade glioma patients.Methods The clinical data of 31 high-grade glioma patients who underwent postoperative radiochemotherapy from June 2008 to June 2009 were reviewed.Pseudoprogression cases were analyzed.The treatment response was assessed through magnetic resonance imaging（MRI） according to the established response evaluation criteria in solid tumors.Results All the 31 high grade gioma patients received postoperative fractioned radiotherapy with concomitant TMZ chemotherapy,followed by TMZ maintenance chemotherapy.Four cases of pseudoprogression occurred after radiotherapy（14%）.Conclusion Doctors should be careful in making early diagnosis for the suspected early progression after TMZ concomitant radiochemotherapy.It would be helpful for management to combine the clinical features of pseudoprogression with functional imaging technology.