Macdonald et al listed response criteria following therapy for a malignant glioma. The authors are from the University of Western Ontario, London Regional Cancer Center (Ontario), Mayo Clinic and Duke University.
Parameters:
(1) change in area for enhancing tumor on MRI or CT
(2) corticosteroid dose
(3) neurological status
(4) appearance of new lesions
area of the tumor in 2 dimensions =
= (longest dimension in cm) * (length of perpendicular axis in cm)
change in area =
= ((area before therapy) - (area after therapy)) / (area before therapy) * 100%
Change in Area
Corticosteroid Dose
Neurologic Status
New Lesions
Term
100% reduction
none or physiologic
stable or improved
none
complete response
76 - 99% reduction
decreased or stable
stable or improved
none
major response
51 - 75% reduction
stable
stable or improved
none
partial response
25% increase to 50% reduction
stable
stable
none
stable
> 25% increase
stable or increased
stable to worse
none
progression
NA
NA
NA
present
progression
where:
• The changes in tumor area should be stable on scans at least 1 month apart.
• The major response category is given by Fortin et al.
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