Ongoing evolution of response assessment in glioma

Abstract

The complex heterogeneity and therapeutic resistance of malignant glioma may largely account for the poor prognosis of glioma. The incomplete response assessment system of clinical outcomes is an underlying cause for the confounding of true prognostic benefits expected in patients with glioma. The investigation and development of recently introduced agents or radiological measurements caused emergent misunderstandings to the response assessment of glioma. To date, the classical Macdonald's criteria and the Response Assessment of Neuro⁃Oncology (RANO) criteria have been used successively for the evaluation of glioma outcome. However, the Macdonald's criteria only addresses the contrast⁃enhancement component of the tumor, which is only a surrogate to true tumor growth and activity. Ongoing efforts on complementary assessments are necessary to combat malignant glioma. In this review, we highlight the shortcomings of the current criteria and introduce the initiative effort of RANO criteria and its offspring.

DOI：10.3969/j.issn.1672⁃6731.2019.11.005