MRI and 18FET-PET Predict Survival Benefit from Bevacizumab Plus Radiotherapy in Patients with Isocitrate Dehydrogenase Wild-type Glioblastoma: Results from the Randomized ARTE Trial.

摘要: Purpose: To explore a prognostic or predictive role of magnetic resonance imaging (MRI) and O-(2-18F-fluoroethyl)-L-tyrosine (18FET) positron emission tomography (PET) parameters for outcome in the randomized multi-center trial ARTE that compared bevacizumab plus radiotherapy with radiotherpay alone elderly patients glioblastoma. Experimental Design: Patients isocitrate dehydrogenase wild-type glioblastoma aged 65 years older were included this post-hoc analysis. Tumor volumetric apparent diffusion coefficient (ADC) analyses serial MRI scans from 67 18FET-PET tumor-to-brain intensity ratios (TBR) 31 analyzed blinded treatment arm outcome. Multivariate Cox regression analysis was done to account established factors arm. Results: Overall survival benefit observed larger pre-treatment contrast-enhancing tumor (hazard ratio [HR] per cm3 0.94, 95% confidence interval [CI] 0.89-0.99) higher ADC (HR 0.18, CI 0.05-0.66). Higher 18FET-TBR on PET associated inferior overall both arms. Response assessed by standard MRI-based RANO criteria trend only (p=0.09). High non-contrast-enhancing portions during therapy multivariate 5.97, 1.16-30.8). Conclusion: Large mass identify who may experience radiotherapy. Persistent signal no longer after concomitant suggests pseudoresponse predicts poor Trial registration: NCT01443676.