Hallo Wolle,
zu deiner Frage die folgende Info.
Alles Gute,
Pit
Titel: Using proton magnetic resonance spectroscopic imaging to predict in vivo the response of recurrent malignant gliomas to tamoxifen chemotherapy
In: Neurosurgery 2000 Feb;46(2):306-18
Hierbei geht es um die VORHERSAGE, ob Tamoxifen (Protein-Kinase-C Hemmer) in der individuellen Gliomtherapie von Nutzen ist. Das Verfahren wurde an der McGill University in Montreal entwickelt.
Übersetzung des Schlußsatzes:
Zusammenfassung: Es ist möglich, auf der Basis von erhältlichen nicht-invasiven biochemischen in vivo Informationen, das Tumoransprechen auf Tamoxifen GENAU VORHERZUSAGEN. Proton Magnetic Resonance Spectroscopic Imaging (1H MRSI) hat das Potential als prognostisches Instrument in der pharmakologischen Behandlung von wiederkehrenden bösartigen Gliomen.
Prof. Villemure (Neurochirurg) ist nun an der Universität von Genf-Lausanne tätig. Leider wendet er dort das Verfahren nicht an. Was die Kollegen in Kanada machen weiss ich leider nicht.
Titel:
Using proton magnetic resonance spectroscopic imaging to predict in vivo the response of recurrent malignant gliomas to tamoxifen chemotherapy.
Preul MC, Caramanos Z, Villemure JG, Shenouda G, LeBlanc R, Langleben A, Arnold DL.
Department of Neurosurgery, McGill University, Montreal, Quebec, Canada.
Neurosurgery 2000 Feb;46(2):306-18
OBJECTIVE: Most patients with a malignant glioma spend considerable time on a treatment protocol before their response (or nonresponse) to the therapy can be determined. Because survival time in the absence of effective therapy is short, the ability to predict the potential chemosensitivity of individual brain tumors noninvasively would represent a significant advance in chemotherapy planning. METHODS: Using proton magnetic resonance spectroscopic imaging (1H MRSI), we studied 16 patients with a recurrent malignant glioma before and during treatment with high-dose orally administered tamoxifen. We evaluated whether 1H MRSI data could predict eventual therapeutic response to tamoxifen at the pretreatment and early treatment stages. RESULTS: Seven patients responded to tamoxifen therapy (three with glioblastomas multiforme; four with anaplastic astrocytomas), and nine did not (six with glioblastomas multiforme; three with anaplastic astrocytomas). Responders and nonresponders exhibited no differences in their age, sex, tumor type, mean tumor volume, mean Karnofsky scale score, mean number of weeks postradiotherapy, or mean amount of prior radiation exposure. Resonance profiles across the five metabolites measured on 1H MRSI spectra (choline-containing compounds, creatine and phosphocreatine, N-acetyl groups, lactate, and lipids) differed significantly between these two groups before and during treatment. Furthermore, linear discriminant analyses based on patients´ in vivo biochemical information accurately predicted individual response to tamoxifen both before and at very early treatment stages (2 and 4 wk). Similar analyses based on patient sex, age, Karnofsky scale score, tumor type, and tumor volume could not reliably predict the response to tamoxifen treatment at the same time periods. CONCLUSION: It is possible to accurately predict the response of a tumor to tamoxifen on the basis of noninvasively acquired in vivo biochemical information. 1H MRSI has potential as a prognostic tool in the pharmacological treatment of recurrent malignant gliomas.
Kontakt:
Prof. Dr. Jean-Guy Villemure
E-Mail: jean-guy.villemure@chuv.hospvd.ch
office phone: +41 21 314 2600
+41 21 314 2602
office address: Service de neurochirurgie CHUV
CH-1011 Lausanne
department: Service des hospices cantonaux-
Service de neurochirurgie
title: Chef de service