Ongoing evolution of response assessment in glioma

doi:10.3969/j.issn.1672-6731.2019.11.005

Abstract

Abstract:

The complex heterogeneity and therapeutic resistance of malignant glioma may largely account for the poor prognosis of glioma. The incomplete response assessment system of clinical outcomes is an underlying cause for the confounding of true prognostic benefits expected in patients with glioma. The investigation and development of recently introduced agents or radiological measurements caused emergent misunderstandings to the response assessment of glioma. To date, the classical Macdonald's criteria and the Response Assessment of Neuro-Oncology (RANO) criteria have been used successively for the evaluation of glioma outcome. However, the Macdonald's criteria only addresses the contrast-enhancement component of the tumor, which is only a surrogate to true tumor growth and activity. Ongoing efforts on complementary assessments are necessary to combat malignant glioma. In this review, we highlight the shortcomings of the current criteria and introduce the initiative effort of RANO criteria and its offspring.

Key words: Glioma, Prognosis, Magnetic resonance imaging, Review

摘要：

脑胶质瘤的异质性和治疗抵抗性可能在很大程度上解释脑胶质瘤的不良预后，但临床疗效反应评价体系的不完整性是导致患者预期预后与真实预后混淆的根本原因。目前经典的Macdonald标准和神经肿瘤反应评价（RANO）标准已长期用于评价脑胶质瘤的治疗反应，但Macdonald标准仅阐述肿瘤的增强对比成分，不能真实反映肿瘤的生长或活性。为抵御这种恶性肿瘤，有必要继续补充评价体系。本文重点介绍经典的Macdonald标准的不足之处，同时推荐RANO标准及其衍生标准的可行性。

关键词: 神经胶质瘤, 预后, 磁共振成像, 综述

YI Li, WANG Xu-ya, CHU Shu-guang, QIN Zhi-yong, YANG Xue-jun. Ongoing evolution of response assessment in glioma[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2019, 19(11): 826-831.

易立, 王旭亚, 初曙光, 秦智勇, 杨学军. 脑胶质瘤疗效评价进展[J]. 中国现代神经疾病杂志, 2019, 19(11): 826-831.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2019.11.005

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