scholarly journals Volumetric Study Reveals the Relationship Between Outcome and Early Radiographic Response During Bevacizumab-Containing Chemoradiotherapy for Unresectable Glioblastoma

2021 ◽  
Author(s):  
Kosuke Takigawa ◽  
Nobuhiro Hata ◽  
Yuhei Michiwaki ◽  
Akio Hiwatashi ◽  
Hajime Yonezawa ◽  
...  
Keyword(s):  
Response Assessment ◽  
Complete Response ◽  
Early Response ◽  
Radiographic Response ◽  
Rano Criteria ◽  
Kaplan Meier ◽  
Fluid Attenuated Inversion Recovery ◽  
Volumetric Study ◽  
Definition Of ◽  
The Relationship

Abstract Purpose: Although we have shown the clinical benefit of bevacizumab (BEV) in the treatment of unresectable newly diagnosed glioblastomas (nd-GBMs), the relationship between early radiographic response and survival outcome remains unclear. We performed a volumetric study of the early radiographic responses in nd-GBMs treated with BEV.Methods: Twenty-two patients with unresectable nd-GBM treated with BEV during concurrent temozolomide radiotherapy were analyzed. Early responses in fluid-attenuated inversion-recovery (FLAIR) and gadolinium-enhanced T1-weighted images (GdT1WI) were interpreted by an experienced neuroradiologist. Volumetric changes were evaluated using diffusion-weighted imaging (DWI) and GdT1WI according to the Response assessment in neuro-oncology (RANO) criteria. The results were categorized into improved (complete response [CR] or partial response [PR]) or non-improved (stable disease [SD] or progressive disease [PD]) groups; outcomes were compared using Kaplan-Meier analysis.Results: The volumetric GdT1WI improvement was a significant predictive factor for overall survival (OS) prolongation (p=0.0093, median OS: 24.7 vs. 13.6 months); however, FLAIR and DWI images were not predictive. The threshold for the neuroradiologist-interpretation of improvement in GdT1WI was nearly 20% of volume reduction, which was lesser than 50%, the definition of PR applied in RANO criteria; however, even less stringent neuroradiologist-interpretation could successfully predict OS prolongation (improved vs. non-improved: p=0.0067, median OS: 17.6 vs. 8.3 months). Significant impact of OS on the early response in volumetric GdT1WI was observed within the cut-off range of 20 to 50% (20%, p=0.0315; 30%, p=0.087; 40%, p=0.0456).Conclusions: Early response during BEV-containing chemoradiation can be a predictive indicator for patient outcome in unresectable nd-GBMs.

scholarly journals Volumetric study reveals the relationship between outcome and early radiographic response during bevacizumab-containing chemoradiotherapy for unresectable glioblastoma

2021 ◽  
Author(s):  
Kosuke Takigawa ◽  
Nobuhiro Hata ◽  
Yuhei Michiwaki ◽  
Akio Hiwatashi ◽  
Hajime Yonezawa ◽  
...  
Keyword(s):  
Response Assessment ◽  
Complete Response ◽  
Early Response ◽  
Radiographic Response ◽  
Rano Criteria ◽  
Kaplan Meier ◽  
Fluid Attenuated Inversion Recovery ◽  
Volumetric Study ◽  
Definition Of ◽  
The Relationship

Abstract Purpose Although we have shown the clinical benefit of bevacizumab (BEV) in the treatment of unresectable newly diagnosed glioblastomas (nd-GBM), the relationship between early radiographic response and survival outcome remains unclear. We performed a volumetric study of early radiographic responses in nd-GBM treated with BEV. Methods Twenty-two patients with unresectable nd-GBM treated with BEV during concurrent temozolomide radiotherapy were analyzed. An experienced neuroradiologist interpreted early responses on fluid-attenuated inversion recovery (FLAIR) and gadolinium-enhanced T1-weighted images (GdT1WI). Volumetric changes were evaluated using diffusion-weighted imaging (DWI) and GdT1WI according to the Response Assessment in Neuro-Oncology (RANO) criteria. The results were categorized into improved (complete response [CR] or partial response [PR]) or non-improved (stable disease [SD] or progressive disease [PD]) groups; outcomes were compared using Kaplan–Meier analysis. Results The volumetric GdT1WI improvement was a significant predictive factor for overall survival (OS) prolongation (p = 0.0093, median OS: 24.7 vs. 13.6 months); however, FLAIR and DWI images were not predictive. The threshold for the neuroradiologist’s interpretation of improvement in GdT1WI was nearly 20% of volume reduction, which was lesser than 50%, the definition of PR applied in the RANO criteria. However, even less stringent neuroradiologist interpretation could successfully predict OS prolongation (improved vs. non-improved: p = 0.0067, median OS: 17.6 vs. 8.3 months). Significant impact of OS on the early response in volumetric GdT1WI was observed within the cut-off range of 20–50% (20%, p = 0.0315; 30%, p = 0.087; 40%, p = 0.0456). Conclusions Early response during BEV-containing chemoradiation can be a predictive indicator of patient outcome in unresectable nd-GBM.

Evaluation of early response by anatomic imaging to predict survival among patients with group III rhabdomyosarcoma: A report from the Children’s Oncology Group.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10012-10012
Author(s):  
Douglas S. Hawkins ◽  
Abby R. Rosenberg ◽  
Elizabeth Lyden ◽  
James Robert Anderson ◽  
David A. Rodeberg ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Objective Response ◽  
Prognostic Significance ◽  
Complete Response ◽  
Early Response ◽  
Response To Therapy ◽  
Rank Test ◽  
Oncology Group ◽  
Group Iii ◽  
Kaplan Meier

10012 Background: The prognostic significance of response to induction therapy for rhabdomyosarcoma (RMS) by anatomic imaging (computerized tomographic [CT] or magnetic resonance imaging [MRI] scan) is controversial. We previously reported no relationship between early response and failure-free survival (FFS) for patients on IRS-IV. We repeated the same analysis using an independent cohort of patients with non-metastatic, initially unresected RMS treated on a more recent clinical trial. Methods: A total of 338 patients enrolled in Children’s Oncology Group study D9803 met the following inclusion criteria for this analysis: 1) non-metastatic, initially unresected (Group III); 2) embryonal (ERMS) or alveolar (ARMS) histology; 3) documented response to induction chemotherapy (excluding progressive disease) based on anatomic imaging; and 4) documented therapy beyond week 12. Response at week 12 was determined by the treating institution as complete response (CR, complete resolution), partial response (PR, decrease of >= 50% of the sum of the products of maximum perpendicular diameters), or no response (NR, between 50% reduction and 25% increase in the sum of the products of maximum perpendicular diameters). FFS was estimated using the Kaplan-Meier method, and comparisons between groups were made using the log-rank test. Results: Overall objective response rate (CR+PR) at week 12 of therapy was 85%, with similar responses for ERMS and ARMS. FFS was similar among all patients with CR, PR, or NR (p=0.49). Restricting the analysis to either ERMS or ARMS, there was no difference in FFS by histology (p=0.20 and p=0.45, respectively). Conclusions: These findings provide additional evidence that anatomic imaging assessment of early response to therapy among RMS patients does not predict outcome and should not be used to tailor subsequent therapy. Clinical trial information: NCT00003958. [Table: see text]

Monitoring response of PDL-1 directed immunotherapy in patients with advanced NSCLC using serum CEA levels.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20509-e20509
Author(s):  
Rajasree Roy ◽  
Wallace Chan ◽  
Dilip Patel ◽  
Sandy Nissel-Horowitz ◽  
Angela Caramalis ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Stage Iv ◽  
Retrospective Chart Review ◽  
Response Assessment ◽  
Early Response ◽  
Smoking History ◽  
Baseline Serum ◽  
Radiographic Response ◽  
Institutional Experience ◽  
Serum Cea

e20509 Background: Immunotherapy (IT) response measurements in advanced NSCLC management are evolving. We describe here our retrospective single institutional experience in measuring serum CEA levels as an early response determinant and correlation with radiographic assesment. Methods: Retrospective chart review was performed after obtaining IRB approval. Demographic information, stage, histology, prior treatment, IT agent used, radiographic response assesment and serum CEA levels were recorded. Patients were evaluable if they had elevated baseline serum CEA levels (normal range non smokers: 0-3 ng/ml, smokers 0-5 ng/ml), had recieved at least two cycles of IT and had radiographic response assessment performed. Results: Six eligible patients were identified. Median age 60 yrs; M:F1:5, SCC n=1, Adeno: n=5; Smoking history positive n=4; Stage IV n=6, EGFR mut+ n=2; IT agent used: nivolumab: n=5; atezolizumab: n=1. IT as 1st line of Rx n=1; 2nd line n=3, 3rd line: n=2. On first radiographic assesment: three patients had progressive disease (PD), Two patients had PR, one patient (#1) had an intial PR and subsequently PD with subsequent rise in CEA level to 16.1 corelating with PD on radiographs. Conclusions: Serum CEA levels appear to correlate well with response assesment in patients with advanced NSCLC while being treated with immunotherapy. This small study is hypothesis generating and is currently being evaluated in a larger series. [Table: see text]

Does RECIST-defined progression correlate with lack of further sunitinib (SU) benefit in advanced renal cell carcinoma (aRCC)?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15093-e15093
Author(s):  
MinYuen Teo ◽  
Raymond S. McDermott
Keyword(s):  
Stable Disease ◽  
Clinical Benefit ◽  
Radiographic Progression ◽  
Clinical Status ◽  
Progression Free Survival ◽  
Response Assessment ◽  
Risk Groups ◽  
Complete Response ◽  
Disease Response ◽  
Kaplan Meier

e15093 Background: RECIST defined radiographic progression on SU may be confounded by the intermittent dosing schedule and scan timing. Response rates to second line agents are typically lower and of shorter duration We analysed the potential for continued clinical benefit from continuation on Sunitinib following RECIST-defined progression in selected pts . Methods: Our institutional database was reviewed to identify aRCC pts who: 1) received SU, 2) achieved response or stable disease, and 3) had continuation of SU after documentation of RECIST-defined progression. Treatment history was obtained from medical chart review. CT scans were retrospectively assessed by RECIST criteria, pattern of progression was documented. SU cessation reasons were identified. Progression-free survival (PFS), post-progression treatment duration (PPD) and overall survival (OS) estimated by Kaplan Meier method. Results: Of 39 patients (pts) treated with SU between 2006 and 2009, 13 met entry criteria. Median age was 62 years (range: 33 – 66) with 11(85%) males. Eleven (85%) had prior nephrectomy and 4 (31%) had prior immunotherapy. Number of pts with MSKCC good/intermediate/poor risk groups were 5/7/1. Best radiographic response achieved was complete response/partial response/stable disease in two, five and six pts. Median PFS was 16.4 mos (11.8 – 23.8). Seven (54%) had progression of existing lesions while the six developed new lesions. Pts continued on SU as progression was relatively minor and clinical status was maintained. Median PPD was 4.2 months (0.6 – 40.5). Most common reasons for SU cessation were on-going radiographic progression (71%) and toxicity (18%). Only 2 pts stopped SU secondary to clinical deterioration. 62% of pts received subsequent lines of treatment, with half receiving 3rd line therapy. Median OS for the cohort was 31.7 mos. Conclusions: Continuation of treatment with SU following RECIST progression appears feasible and safe with prolonged disease control in selected pts . This approach should be further validated prospectively in a larger patient cohort. In this group, current standards for disease response assessment may underestimate the duration of clinical benefit conferred.

scholarly journals Early Pseudoprogression following Chemoradiotherapy in Glioblastoma Patients: The Value of RANO Evaluation

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Paulo Linhares ◽  
Bruno Carvalho ◽  
Rita Figueiredo ◽  
Rui M. Reis ◽  
Rui Vaz
Keyword(s):  
Survival Data ◽  
Response Assessment ◽  
Rank Analysis ◽  
Rano Criteria ◽  
Macdonald Criteria ◽  
Kaplan Meier ◽  
Early Progression ◽  
Radiological Response ◽  
The Impact ◽  
True Progression

Introduction. The aim of this study was to determine the frequency of pseudoprogression in a cohort of glioblastoma (GBM) patients following radiotherapy/temozolomide (RT/TMZ) by comparing Macdonald criterial to Response Assessment in Neuro-Oncology (RANO) criteria. The impact on prognosis and survival analysis was also studied.Materials and Methods. All patients receiving RT/TMZ for newly diagnosed GBM from January 2005 to December 2009 were retrospectively evaluated, and demographic, clinical, radiographic, treatment, and survival data were reviewed. Updated RANO criteria were used for the evaluation of the pre-RT and post-RT MRI and compared to classic Macdonald criteria. Survival data was evaluated using the Kaplan-Meier and log-rank analysis.Results and Discussion. 70 patients were available for full radiological response assessment. Early progression was confirmed in 42 patients (60%) according to Macdonald criteria and 15 patients (21%) according to RANO criteria. Pseudoprogression was identified in 10 (23.8%) or 2 (13.3%) patients in Macdonald and RANO groups, respectively. Cumulative survival of pseudoprogression group was higher than that of true progression group and not statistically different from the non-progressive disease group.Conclusion. In this cohort, the frequency of pseudoprogression varied between 13% and 24%, being overdiagnosed by older Macdonald criteria, which emphasizes the importance of RANO criteria and new radiological biomarkers for correct response evaluation.

scholarly journals Dose-Intensive Response-Based Chemotherapy and Radiation Therapy for Children and Adolescents With Newly Diagnosed Intermediate-Risk Hodgkin Lymphoma: A Report From the Children's Oncology Group Study AHOD0031

2014 ◽  
Vol 32 (32) ◽  
pp. 3651-3658 ◽  
Author(s):  
Debra L. Friedman ◽  
Lu Chen ◽  
Suzanne Wolden ◽  
Allen Buxton ◽  
Kathleen McCarten ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Response Assessment ◽  
Complete Response ◽  
Early Response ◽  
Phase Iii ◽  
Chemotherapy Response ◽  
Intermediate Risk ◽  
Oncology Group ◽  
Oncology Group Study ◽  
To Receive

Purpose The Children's Oncology Group study AHOD0031, a randomized phase III study, was designed to evaluate the role of early chemotherapy response in tailoring subsequent therapy in pediatric intermediate-risk Hodgkin lymphoma. To avoid treatment-associated risks that compromise long-term health and to maintain high cure rates, dose-intensive chemotherapy with limited cumulative doses was used. Patients and Methods Patients received two cycles of doxorubicin, bleomycin, vincristine, etoposide, cyclophosphamide, and prednisone (ABVE-PC) followed by response evaluation. Rapid early responders (RERs) received two additional ABVE-PC cycles, followed by complete response (CR) evaluation. RERs with CR were randomly assigned to involved-field radiotherapy (IFRT) or no additional therapy; RERs with less than CR were nonrandomly assigned to IFRT. Slow early responders (SERs) were randomly assigned to receive two additional ABVE-PC cycles with or without two cycles of dexamethasone, etoposide, cisplatin, and cytarabine (DECA). All SERs were assigned to receive IFRT. Results Among 1,712 eligible patients, 4-year event-free survival (EFS) was 85.0%: 86.9% for RERs and 77.4% for SERs (P < .001). Four-year overall survival was 97.8%: 98.5% for RERs and 95.3% for SERs (P < .001). Four-year EFS was 87.9% versus 84.3% (P = .11) for RERs with CR who were randomly assigned to IFRT versus no IFRT, and 86.7% versus 87.3% (P = .87) for RERs with positron emission tomography (PET) –negative results at response assessment. Four-year EFS was 79.3% versus 75.2% (P = .11) for SERs who were randomly assigned to DECA versus no DECA, and 70.7% versus 54.6% (P = .05) for SERs with PET-positive results at response assessment. Conclusion This trial demonstrated that early response assessment supported therapeutic titration (omitting radiotherapy in RERs with CR; augmenting chemotherapy in SERs with PET-positive disease). Strategies directed toward improved response assessment and risk stratification may enhance tailoring of treatment to patient characteristics and response.

scholarly journals Retrospective Study of the Safety and Efficacy of Anlotinib Combined With Dose-Dense Temozolomide in Patients With Recurrent Glioblastoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Lei She ◽  
Lin Su ◽  
Liangfang Shen ◽  
Chao Liu
Keyword(s):  
Survival Curve ◽  
Progression Free Survival ◽  
Response Assessment ◽  
Complete Response ◽  
Recurrent Glioblastoma ◽  
First Line ◽  
Rano Criteria ◽  
First Line Therapy ◽  
Line Therapy ◽  
Dose Dense

PurposeThe purpose of this study was to retrospectively analyze the safety and clinical efficacy of anlotinib combined with dose-dense temozolomide (TMZ) as the first-line therapy in the treatment of recurrent glioblastoma (rGBM).Patients and MethodsWe collected the clinical data of 20 patients with rGBM. All patients received anlotinib (12 mg daily, orally for 2 weeks, discontinued for 1 week, repeated every 3 weeks) combined with dose-dense TMZ (100 mg/m2, 7 days on with 7 days off) until the disease progressed (PD) or adverse effects (AEs) above grade 4 appeared. Grade 3 AEs need to be restored to grade 2 before continuing treatment, and the daily dose of anlotinib is reduced to 10 mg. The patients were reexamined by head magnetic resonance imaging (MRI) every 1 to 3 months. The therapeutic effect was evaluated according to Response Assessment in Neuro-Oncology (RANO) criteria. The survival rate was analyzed by Kaplan-Meier survival curve analysis. The baseline of all survival index statistics was the start of anlotinib combined with dose-dense of TMZ. National Cancer Institute-Common Terminology Criteria Adverse Events version 4.0 (NCI-CTCAE 4.0) was used to evaluate AEs.ResultsTwenty cases of rGBM were evaluated according to the RANO criteria after treatment with anlotinib and dose-dense TMZ, including five cases of stable disease (SD), thirteen cases of partial response (PR), one case of complete response (CR), and one case of PD. The median follow-up time was 13.4 (95% CI, 10.5–16.3) months. The 1-year overall survival (OS) rate was 47.7%. The 6-month progression-free survival (PFS) rate was 55%. In the IDH wild type group, the median PFS and median OS were 6.1 and 11.9 months, respectively. We observed that AEs associated with treatment were tolerable. One patient stopped taking the drug because of cerebral infarction. There were no treatment-related deaths.ConclusionAnlotinib combined with dose-dense TMZ for the first-line therapy showed good efficacy in OS, PFS, ORR, and DCR in the treatment of rGBM, and the AEs were tolerant. Randomized controlled clinical trials investigating the treatment of rGBM with anlotinib are necessary.

PREDICTORS OF CHEMORESISTANCE TO PLATINUM-CONTAINING NEOADJUVANT CHEMOTHERAPY IN ADVANCED OVARIAN CANCER

2019 ◽  
Vol 65 (3) ◽  
pp. 422-426
Author(s):  
Dinara Dolgova ◽  
Snezhanna Gening ◽  
Tatyana Abakumova ◽  
Inna Antoneeva ◽  
Tatyana Gening ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Primary Tumor ◽  
Tumor Tissue ◽  
Advanced Ovarian Cancer ◽  
Complete Response ◽  
Free Survival ◽  
Kaplan Meier ◽  
Relationship Of ◽  
The Relationship

Chemoresistance is one of the main causes of treatment failure in advanced ovarian cancer (OC). In order to identify predictors of chemoresistance, 30 patients with ascitic form of OC, who received neoadjuvant chemotherapy (NACT) according to AP regimen, were examined. In the epithelial cells of ascites and in tumor tissue after NACT, expression of the VEGFa, ABCB1 and ERCC1 genes was assessed by PCR-RT. The effectiveness of NACT was assessed using the criteria of therapeutic pathomorphosis, survival - using the Kaplan-Meier criterion, the relationship of clinical and molecular parameters - using the Mann-Whitney criterion. Results. We established that in 43% of patients the response to NACT was absent (CRS1), the significant response (CRS2) was in 35% of cases, and the complete response (CRS3) was in 21% of cases. VEGFa expression was increased in ascites in 17% of cases, in tumor tissue - in 33% in the CRS1 group. In groups with CRS 2,3, overexpression of VEGFa in ascites was detected in 25% of cases, in tumor tissue in 37.5%. ABCB1 mRNA expression was increased after NACT in 50% of cases in the CRS1 group and in 25% of cases in the CRS 2,3 group. Thus, platinum-based NACT initiates an increase in the expression of VEGFa and ABCB1 in tumor tissue. We established that in case of high expression (ERCC + / VEGF + / ABCB1 +) in ascites, there is a statistically significant increase in relapse-free survival compared with the group with low or absent expression (p = 0.012). The overall survival rate was 41.8 months in patients with overexpression of the studied genes in the tissue of the primary tumor after NACT and 25.3 months in patients with low expression (p = 0.058). Conclusion. The levels of ERCC1, VEGFa and ABCB1 mRNA in ascitic cells before NACT and in the primary tumor after NACT according to the AP scheme can serve as a predictor of the effectiveness of this treatment in ascitic OC.

scholarly journals Long-Term Results of CCG 5942: A Randomized Comparison of Chemotherapy With and Without Radiotherapy for Children With Hodgkin's Lymphoma—A Report From the Children's Oncology Group

2012 ◽  
Vol 30 (26) ◽  
pp. 3174-3180 ◽  
Author(s):  
Suzanne L. Wolden ◽  
Lu Chen ◽  
Kara M. Kelly ◽  
Philip Herzog ◽  
Gerald S. Gilchrist ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Response Assessment ◽  
Complete Response ◽  
Early Response ◽  
Hodgkin's Lymphoma ◽  
Long Term Results ◽  
Entire Cohort ◽  
Long Term Study ◽  
Response To Chemotherapy

Purpose In 1995, the Children's Cancer Group (CCG) opened a trial for patients with Hodgkin's lymphoma evaluating whether low-dose involved-field radiation therapy (IFRT) improved event-free survival (EFS) for patients achieving a complete response after chemotherapy. We present the long-term study outcome using final data through March 2007. Patients and Methods Between January 1995 and December 1998, 826 eligible patients were enrolled onto CCG 5942. Four hundred ninety-eight patients achieving an initial complete response to chemotherapy were randomly assigned to receive IFRT or no further therapy. EFS and overall survival (OS) were assessed from the date of study entry or random assignment, as appropriate. Results Ten-year EFS and OS rates for the entire cohort were 83.5% and 92.5%, respectively. In an as-treated analysis for randomly assigned patients, the 10-year EFS and OS rates were 91.2% and 97.1%, respectively, for IFRT and 82.9% and 95.9%, respectively, for no further therapy. For EFS and OS comparisons, P = .004 and P = .50, respectively. Bulk disease, “B” symptoms, and nodular sclerosis histology were risk factors for inferior EFS. Conclusion With a median follow-up of 7.7 years, IFRT produced a statistically significant improvement in EFS but no improvement in OS. For individual patients, the relative risks of relapse versus late effects of IFRT must be considered. Patient and disease characteristics and early response assessment will aid in deciding which patients are most likely to benefit from IFRT.

scholarly journals NCOG-40. IMPLEMENTING RANO CRITERIA IN A RESOURCE-LIMITED SETTING AND ITS ASSOCIATION WITH OVERALL SURVIVAL OF GLIOMA PATIENTS: EXPERIENCE FROM A NATIONAL CANCER CENTER IN INDONESIA

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii137-ii138
Author(s):  
Rusdy Ghazali Malueka ◽  
Henry Sofyan ◽  
Tiara Aninditha ◽  
Rini Andriani
Keyword(s):  
Overall Survival ◽  
Cox Regression ◽  
Demographic Data ◽  
Response Assessment ◽  
Cancer Center ◽  
Cox Regression Analysis ◽  
Rano Criteria ◽  
Cancer Hospital ◽  
Resource Limited ◽  
Kaplan Meier

Abstract INTRODUCTION Gliomas are one of the most common central nervous system tumors in adults. The Response Assessment Criteria in Neuro-Oncology (RANO) was developed to standardize the radiographic parameters used to assess therapeutic outcomes in glioma patients. A previous study has shown an association between therapeutic response based on RANO criteria and overall survival in glioma patients. However, the feasibility of applying RANO criteria in settings with limited resources has never been reported. This study aims to assess the feasibility of applying RANO criteria in clinical settings in Indonesia. This study also wants to see the role of the RANO criteria as a prognostic factor for gliomas in Indonesia. METHOD Data of glioma patients were retrospectively collected from Dharmais Cancer Hospital in Jakarta, Indonesia. Dharmais Cancer Hospital is the highest referral hospital for brain tumors in the country. Clinical and demographic data were collected from the medical record. RESULTS From 138 identified glioma patients from 2017 to May 2020, only 34 patients can be assessed using RANO criteria. The majority of the patients do not have post-surgical MRI that can be used as a baseline. Among 34 included patients, 38.2% were categorized as responsive, 23.5% as stable disease and 38.2% were categorized as progressive. Kaplan-Meier analysis showed that the median overall survival in the progressive group is significantly shorter than the median survival of responsive/stable group (21.2 vs. 57.5 months respectively, p=0.001). Multivariate cox regression analysis was performed to see the association of RANO criteria and other confounding variables (sex, age, glioma grade, glioma location, and therapy) with overall survival. The result showed that RANO progression was significantly associated with decreased survival (HR 18.38, p=0.045). CONCLUSION This retrospective analysis demonstrates the feasibility of applying RANO criteria in Indonesia and its association with overall survival.

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