Clinical importance of ADC in the prediction of 125I in the treatment for gliomas

Congxiao Wang; Zhijian Xu; Song Wang; Lijing Peng; Wei Zhang; Xueda Li; Lili Yang; Ying Luan; Tao Su; Zixiang Li; Xiaokun Hu

doi:10.7150/jca.50789

Clinical importance of ADC in the prediction of ¹²⁵I in the treatment for gliomas

J Cancer. 2021 Jan 30;12(7):1945-1951. doi: 10.7150/jca.50789. eCollection 2021.

Authors

Congxiao Wang¹, Zhijian Xu², Song Wang¹, Lijing Peng³, Wei Zhang¹, Xueda Li¹, Lili Yang¹, Ying Luan⁴, Tao Su¹, Zixiang Li¹, Xiaokun Hu¹

Affiliations

¹ Department of the Interventional Medical Center, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China.
² JinHua Municipal Central Hospital, JinHua, 321000, Zhejiang, China.
³ Department of Clinical Laboratory, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China.
⁴ Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, China.

Abstract

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: 125I brachytherapy; Gliomas; minimum ADC.