Patient selection: malignant glioma treated with chemoradiation
Progression was defined as
(1) >= 25% increase in size on MRI scan at 4 weeks after treatment
(2) on stable or higher dose of dexamethasone
(3) with or without neurologic deterioration
where:
• The size was based on the area of contrast enhancement.
True progression:
(1) additional disease progression (clinical and radiological) within the following 6 months
Pseudoprogression - one of the following:
(1) >= 50% decrease in the size of the enhancing lesion AND neurologically stable AND on a stable or decreasing dose of dexamethasone
(2) clinically and radiologically stable AND on a stable or decreasing dose of dexamethasone AND no or adjuvant chemotherapy doses (= no additional disease progression)
where:
• A patient who is radiologically "stable" implies no significant change in size. It would seem then that pseudoprogression is anyone who is not true progression.
There will be patients who fit into neither group (those receiving an increased dose of dexamethasone, those receiving additional treatment cycles).