Abstract Details

Title Characterization of Radiation Necrosis in Long-Term Survivors (LTS) of Primary Glioblastoma

Topic Neuro-oncology

Presentation(s) P07 - (-)

Poster/Presentation
Number 012

Objective

Background BACKGROUND: Overall survival of primary GBM patients continues to be very poor, with less than 3% surviving at 5 years, regardless of recent therapeutic advances. Radiation necrosis often presents a diagnostic challenge in assessing treatment effects versus tumor progression.

Design/Methods DESIGN/METHODS: In a single-center retrospective analysis, we identified primary GBM LTS as defined by survival ?5 yrs from diagnosis. To qualify, subjects had to be seen at Preston Robert Tisch Brain Tumor Center at Duke from January 1, 1998 to August 31, 2011, have a pathologically confirmed diagnosis of glioblastoma, and be 18 to 70 years of age. Demographic data was obtained along with further analysis of available pathological specimens for radiation necrosis and possible treatment modalities.

Results RESULTS: A total of 139 primary GBM subjects were identified as LTS. Their average age was 45.2 years (sd=11.9). In this population, 26 (18.7%) subjects had histologically proven radiation necrosis. The percent of female patients was 53.8% (n=14). The mean time from diagnosis of glioblastoma to diagnosis of radiation necrosis was 2.35 years (95% CI 1.5 to 3.2). Treatment was required in 13 patients (50%) and treatments included pentoxifylline with vitamin E, bevacizumab, and hyperbaric oxygen. For the other 50% of patients, treatment was not required but patients continue to have evaluations with serial magnetic resonance imaging. Despite the presentation of pathologically documented radiation necrosis and treatment response, 11 patients (42%) experienced recurrence of glioblastoma.

Conclusions CONCLUSIONS: This work represents the first documentation of the characterization and incidence of radiation necrosis in primary GBM LTS. Continued close monitoring with routine magnetic resonance imaging and close neurological examinations is warranted in this population, particularly when there can be late recurrence of primary GBM despite previously diagnosed radiation necrosis.

Authors/Disclosures
Danijela Levacic, MD (Baylor Scott & White) PRESENTER	No disclosure on file
Katherine B. Peters, MD, PhD, FAAN (Duke University Medical Center)	Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Servier. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sapience. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ONO Pharmaceutical. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Telix. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AnHeart. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Rigel. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Nuvation. The institution of Dr. Peters has received research support from Biomimetix. The institution of Dr. Peters has received research support from Servier. The institution of Dr. Peters has received research support from Varian. The institution of Dr. Peters has received research support from Sapience. The institution of Dr. Peters has received research support from Ono Pharmaceuticals/Deciphera. The institution of Dr. Peters has received research support from Nuvation. The institution of Dr. Peters has received research support from Novocure. The institution of Dr. Peters has received research support from Curis.
Sami L. Khella, MD, FAAN (Presbyterian Med Ctr/Dept of Neuro)	Dr. Khella has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ionis. Dr. Khella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ionis. Dr. Khella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer. Dr. Khella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alnylam. Dr. Khella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eidos.
Kenneth C. Gorson, MD (Kenneth Gorson, MD)	Dr. Gorson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Annexon. Dr. Gorson has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Gorson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ArgenX. Dr. Gorson has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer.

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