tailieunhanh - Báo cáo khoa học: " A case report of pseudoprogression followed by complete remission after proton-beam irradiation for a low-grade glioma in a teenager: the value of dynamic contrast-enhanced MRI"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Radiation Oncology cung cấp cho các bạn kiến thức về ngành y đề tài: " A case report of pseudoprogression followed by complete remission after proton-beam irradiation for a low-grade glioma in a teenager: the value of dynamic contrast-enhanced MRI. | Meyzer et al. Radiation Oncology 2010 5 9 http content 5 1 9 RADIATION ONCOLOGY CASE REPORT Open Access A case report of pseudoprogression followed by complete remission after proton-beam irradiation for a low-grade glioma in a teenager the value of dynamic contrast-enhanced MRI 1 3 5 Candice Meyzer Frédéric Dhermain Denis Ducreux Jean-Louis Habrand Pascale Varlet Christian Sainte-Rose6 Christelle Dufour1 Jacques Grill1 Abstract A fourteen years-old boy was treated post-operatively with proton therapy for a recurrent low-grade oligodendroglioma located in the tectal region. Six months after the end of irradiation RT a new enhancing lesion appeared within the radiation fields. To differentiate disease progression from radiation-induced changes dynamic susceptibility contrast-enhanced DSCE MRI was used with a T2 sequence to study perfusion and permeability characteristics simultaneously. Typically the lesion showed hypoperfusion and hyperpermeability compared to the controlateral normal brain. Without additional treatment but a short course of steroids the image disappeared over a six months period allowing us to conclude for a pseudo-progression. The patient is alive in complete remission more than 2 years post-RT. Background The occurrence of new contrast enhancing lesions on routine MRI follow-up after radiation therapy RT for brain gliomas was observed more than ten years ago but remains problematic because standard MR imaging techniques do not allow a clear distinction between recurrent tumour and radiation-induced lesions 1 2 . Recently pseudo-progression was defined as conventional MR images compatible with progression occurring shortly after concomitant radio-chemotherapy CRC as a transient phenomenon with spontaneous improvement or stabilization after several months 3-5 . This was mainly described in adult and paediatric populations with high-grade gliomas whose new standard of care is CRC followed by adjuvant chemotherapy 6 7 . We