赛克-胶质瘤临床治疗影像学评价.pptVIP

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2018-05-20 发布于四川
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赛克-胶质瘤临床治疗影像学评价.ppt

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* * * * 脑肿瘤中，未进行过RECIST前瞻研究。 * * * * * * * * * * Clinical course of pseudoprogression in a 65-year-old patient with glioblastoma multiforme. (A) Presurgical MRI scan. (B) Postsurgical MRI scan. (C) MRI scan performed 1 month after combined temozolomide (TMZ)/radiotherapy; adjuvant TMZ was continued. (D) Four months later, during administration of maintenance TMZ. (E) Eight months later, during administration of maintenance TMZ. * * * * * * * * 59岁男性，7疗程AVASTIN+CPT-11 * * * * (A)Response to VEGF trap; (B)Discontinuation of VEGF trap; (C)4 weeks after discontinuation; (D) Start * * * * * * * * * * Response Assessment in Neuro-Oncology Ke SAI M.D. Ph.D. Department of neurosurgery Sun Yat-sen University Cancer Center 11/11/2011 Guangzhou IncidenceDistribution of All Gliomas by Histology Subtypes Glioblastoma50.7% All Other Astrocytomas9.1% Anaplastic Astrocytoma7.9% Diffuse Astrocytoma1.7% Pilocytic Astrocytoma5.7% Oligodendrogliomas9.2% Ependymomas5.6% All Other Gliomas10.1% CBTRUS Report, 2004–2005. Prognostic Classification World Health Organization (WHO) Classification System Released in 1993; updated in 2007 Tumors classified by cell origin and level of aggression(Grades I–IV)1,2 Grade Histology Proportion of All Gliomas Median Survival (y)2 I Pilocytic astrocytoma 5% 10 II Well-differentiated astrocytoma 25%–30% 5 III Anaplastic astrocytoma 25%–30% 3 IV Glioblastoma multiforme 40%–50% 1 1. Wen PY, Kesari S. N Engl J Med. 2008;359:492-507. 2. DeAngelis LM. N Engl J Med. 2001;344:114-123. Why is response assessment critical? Treatment decisions Why is response assessment critical? Clinical trials Overall survival (OS) Progression-free survival (PFS) Radiographic response rate (RR) Measurements for RA RECIST Criteria Macdonald Criteria RANO Response Criteria Measurements for RA RECIST Criteria Response Evaluation Criteria in Solid Tumors Introduced in 2000. Updated in 2009 Single lesion: longest diameter in the axial plane