Abstract
Pseudoprogression is a radiological phenomenon in which tumors develop new areas of contrast enhancement in the 6 months following chemoradiotherapy that is often difficult to distinguish from true disease progression. We hypothesized that in Oligodendrogliomas (OG) and Mixed Oligoastrocytomas (MOA) new early contrast enhancement on MRI was unlikely to be associated with true tumor progression. We retrospectively identified 12 patients with either OG or MOA who had new areas of contrast enhancement and underwent second-look surgery within 6 months of receiving radiation with or without chemotherapy. Among these patients, there were no cases of progression to a higher grade, 9 of 12 had greater than 50% radiation necrosis and the remaining 3 had minimal radiation necrosis. Within this group 6 underwent sub-total resection, 3 had gross-total resection, and 3 had biopsy only. Notably, second-look surgery was associated with significant morbidity. Our findings support the hypothesis that early contrast enhancement following chemo-radiotherapy is frequently pseudoprogression.
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