J Cancer 2021; 12(7):1945-1951. doi:10.7150/jca.50789 This issue
1. Department of the Interventional Medical Center, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China.
2. Department of Clinical Laboratory, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China.
3. JinHua Municipal Central Hospital, JinHua, 321000, Zhejiang, China.
4. Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, China.
Objectives: To determine whether the minimum apparent diffusion coefficient (minADC) value can stratify survival in patients with glioma before 125I brachytherapy.
Methods: The study was approved by the Institutional Review Board, and the requirement for informed consent was waived. Twenty-three patients (16 male, 7 female; median age, 48 years) with high-grade glioma (HGG) (n=9) or recurrence after multimodal treatment (n=14) were included in this study. minADC values were obtained before 125I implantation. Overall survival (OS) and progression-free survival (PFS) were analyzed with Cox proportional hazards regression models and the Kaplan-Meier method with the log-rank test.
Results: For 125I-treated patients, the hazard ratio for OS in patients with ADC≥1.0*10^-3 mm2·sec-1 (high minADC) versus ADC<1.0*10^-3 mm2·sec-1 (low minADC) was 0.220 (95% confidence interval: 0.066, 0.735). The median OS was 12 months for patients with high minADC values and 6.0 months for those with low minADC values, and the differences were significant (p=0.032). The median PFS was 12 months for patients with high minADC values and 4 months for those with low minADC values. Significant differences were found in the long-rank test (p=0.013). The multivariate analysis results showed that minADC pre-125I implantation was an independent predictor of OS and PFS in patients receiving 125I brachytherapy.
Conclusions: Pre-125I implantation ADC analysis can stratify prognosis in 125I-treated patients with glioma, which may aid in choosing a suitable therapy for glioma patients.
Keywords: Gliomas, minimum ADC, 125I brachytherapy