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dc.contributor.authorAl Feghali, Karine A
dc.contributor.authorRandall, James W
dc.contributor.authorLiu, Diane D
dc.contributor.authorWefel, Jeffrey S
dc.contributor.authorBrown, Paul D
dc.contributor.authorGrosshans, David R
dc.contributor.authorMcAvoy, Sarah A
dc.contributor.authorFarhat, Maguy A
dc.contributor.authorLi, Jing
dc.contributor.authorMcGovern, Susan L
dc.contributor.authorMcAleer, Mary F
dc.contributor.authorGhia, Amol J
dc.contributor.authorPaulino, Arnold C
dc.contributor.authorSulman, Erik P
dc.contributor.authorPenas-Prado, Marta
dc.contributor.authorWang, Jihong
dc.contributor.authorde Groot, John
dc.contributor.authorHeimberger, Amy B
dc.contributor.authorArmstrong, Terri S
dc.contributor.authorGilbert, Mark R
dc.contributor.authorMahajan, Anita
dc.contributor.authorGuha-Thakurta, Nandita
dc.contributor.authorChung, Caroline
dc.date.accessioned2021-08-04T15:40:47Z
dc.date.available2021-08-04T15:40:47Z
dc.date.issued2021-06-01
dc.identifier.urihttp://hdl.handle.net/10713/16303
dc.description.abstractBackground: This secondary image analysis of a randomized trial of proton radiotherapy (PT) versus photon intensity-modulated radiotherapy (IMRT) compares tumor progression based on clinical radiological assessment versus Response Assessment in Neuro-Oncology (RANO). Methods: Eligible patients were enrolled in the randomized trial and had MR imaging at baseline and follow-up beyond 12 weeks from completion of radiotherapy. “Clinical progression” was based on a clinical radiology report of progression and/or change in treatment for progression. Results: Of 90 enrolled patients, 66 were evaluable. Median clinical progression-free survival (PFS) was 10.8 (range: 9.4–14.7) months; 10.8 months IMRT versus 11.2 months PT (P = .14). Median RANO-PFS was 8.2 (range: 6.9, 12): 8.9 months IMRT versus 6.6 months PT (P = .24). RANO-PFS was significantly shorter than clinical PFS overall (P = .001) and for both the IMRT (P = .01) and PT (P = .04) groups. There were 31 (46.3%) discrepant cases of which 17 had RANO progression more than a month prior to clinical progression, and 14 had progression by RANO but not clinical criteria. Conclusions: Based on this secondary analysis of a trial of PT versus IMRT for glioblastoma, while no difference in PFS was noted relative to treatment technique, RANO criteria identified progression more often and earlier than clinical assessment. This highlights the disconnect between measures of tumor response in clinical trials versus clinical practice. With growing efforts to utilize real-world data and personalized treatment with timely adaptation, there is a growing need to improve the consistency of determining tumor progression within clinical trials and clinical practice.en_US
dc.description.urihttps://doi.org/10.1093/noajnl/vdab073en_US
dc.description.urihttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/34337411/en_US
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.relation.ispartofNeuro-oncology Advancesen_US
dc.rights© The Author(s) 2021. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.en_US
dc.subjectRANOen_US
dc.subjectglioblastomaen_US
dc.subjectimaging endpointsen_US
dc.subjectprogression-free survivalen_US
dc.subjectradiation therapyen_US
dc.titlePhase II trial of proton therapy versus photon IMRT for GBM: secondary analysis comparison of progression-free survival between RANO versus clinical assessmenten_US
dc.typeArticleen_US
dc.identifier.doi10.1093/noajnl/vdab073
dc.identifier.pmid34337411
dc.source.volume3
dc.source.issue1
dc.source.beginpagevdab073
dc.source.endpage
dc.source.countryEngland


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