≥12 Weeks after |
A new contrast-enhancing lesion outside of the radiation field on declining, stable, or increasing doses of corticosteroids.
Increase by 25% or more in the sum of the products of the perpendicular diameters from the first post-radiotherapy imaging (or subsequent imaging showing a smaller tumour size) to the imaging at 12 weeks or later on stable or increasing doses of corticosteroids.
Clinical deterioration not attributable to concurrent medication or comorbid conditions is sufficient to declare progression on current treatment, but not for entry onto a clinical trial for recurrence.
For patients receiving antiangiogenic therapy, a significant increase in a T2 or FLAIR (fluid-attenuated inversion recovery) non-enhancing lesion can also be considered progressive disease. The increased T2 or FLAIR must have occurred compared with baseline imaging or the best response after initiation of therapy, with the patient on stable or increasing doses of corticosteroids, and must not be a result of comorbid events (for example, effects of radiation therapy, demyelination, ischemic injury, infection, seizures, postoperative changes, or other treatment effects).
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