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IMAGING of TREATMENT RESPONSE
PSEUDO-PROGRESSION
PSEUDO-PROGRESSION
is a self-limited type of treatment-related tissue injury
that is common in the first 3-6 months after TMZ and radiation therapy, and mimics
tumor progression, but then stabilises and decreases
(Brandsma D et al. Lancet oncol
2008) – up to 30% of high grade gliomas, also seen in low grade gliomas-
-more frequent in MGMT Met tumours
Differ from classic radiation necrosis, which can also mimics tumor progression,
but is typically more severe and delayed in onset.
Before RT+TMZ
Before adjuvant TMZ After 2 cycles adj TMZ
RANO criteria: within the first 12 weeks following completion of radiotherapy,
progression can only be determined if new enhancement is seen outside of
the radiation field or if there is histopathological confirmation