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Using
proton magnetic resonance spectroscopic imaging to predict in vivo the response
of recurrent malignant gliomas to tamoxifen chemotherapy
Preul
MC, Caramanos Z, Villemure JG, Shenouda G, LeBlanc R, Langleben A, Arnold DL
Department
of Neurosurgery, McGill University, Montreal, Quebec, Canada
Objective.
Most patients with a malignant glioma spend considerable time on a treatment
protocol before their response (or nonresponse) to the therapy can be
determined.
Because survival time in the absence of effective therapy is short, the ability
to predict the potential chemosensitivity of individual brain tumors
noninvasively would represent a significant advance in chemotherapy planning.
Methods.
Using proton magnetic resonance spectroscopic imaging (1H MRSI), we studied 16
patients with a recurrent malignant glioma before and during treatment with
high-dose orally administered tamoxifen.
We evaluated whether 1H MRSI data could predict eventual therapeutic response to
tamoxifen at the pretreatment and early treatment stages.
Results.
Seven patients responded to tamoxifen therapy (three with glioblastomas
multiforme; four with anaplastic astrocytomas), and nine did not (six with
glioblastomas multiforme; three with anaplastic astrocytomas).
Responders and nonresponders exhibited no differences in their age, sex, tumor
type, mean tumor volume, mean Karnofsky scale score, mean number of weeks
postradiotherapy, or mean amount of prior radiation exposure.
Resonance profiles across the five metabolites measured on 1H MRSI spectra (choline-containing
compounds, creatine and phosphocreatine, N-acetyl groups, lactate, and lipids)
differed significantly between these two groups before and during treatment.
Furthermore, linear discriminant analyses based on patients' in vivo biochemical
information accurately predicted individual response to tamoxifen both before
and at very early treatment stages (2 and 4 wk).
Similar analyses based on patient sex, age, Karnofsky scale score, tumor type,
and tumor volume could not reliably predict the response to tamoxifen treatment
at the same time periods.
Conclusion.
It is possible to accurately predict the response of a tumor to tamoxifen on the
basis of noninvasively acquired in vivo biochemical information.
1H MRSI has potential as a prognostic tool in the pharmacological treatment of
recurrent malignant gliomas.
PMID:
10690719 [PubMed - indexed for MEDLINE]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10690719&dopt=Abstract
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