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Impact of Angiotensin-II receptor blockers on vasogenic edema in glioblastoma patients

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Abstract

Glioblastoma patients often require chronic administration of steroids due to peri-tumoral edema. Preliminary studies showed that treatment with Angiotensin-II Receptor Blockers (ARBs) for high blood pressure might be associated with reduced peri-tumoral edema. In this study, we aim to radiologically assess the effect of ARBs on peri-tumoral edema. We conducted a cross-sectional survey on patients with newly diagnosed GBM. Patients treated with ARBs for high blood pressure were paired to non ARB-treated patients based on similar age, tumor location and tumor size. Patients taking steroids at the time of pre-operative Magnetic Resonance Imaging were excluded from the study. In each pair of patients, we compared the volumes of peri-tumoral hyper T2-Fluid Attenuated Inversion Recovery (FLAIR) signal and the Apparent Diffusion Coefficient (ADC) in the same area. Eleven (11) ARB-treated patients were selected and paired to 11 non ARB-treated controls. Volumes of peri-tumoral hyper T2-FLAIR signal were significantly lower in the ARB-treated group than in the non ARB-treated group (p = 0.02). Additionally, peri-tumoral ADCs were also significantly lower in the treated group (p = 0.02), suggesting that the peri-tumoral area in this group had less edematous features. These results suggest that ARBs may reduce the volume of peri-tumoral hyper T2-FLAIR signal by decreasing edema.

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Acknowledgments

This work was supported by the Association Oligocyte, the Association pour le développement des neurosciences à Avicenne (ADNA) and the Assistance Publique-Hôpitaux de Paris (AP/HP).

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Authors and Affiliations

  1. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurologie, de l’Hôpital Avicenne, 125 route de Stalingrad, 93009, Bobigny, France

    Antoine Kourilsky, Renata Ursu, Jennifer Doridam, Ciprian Barlog, Catherine Belin & Antoine F. Carpentier

  2. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de radiologie, Hôpital Avicenne, 93009, Bobigny, France

    Guillaume Bertrand

  3. UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, 93009, Bobigny, France

    Jennifer Doridam, Ciprian Barlog & Antoine F. Carpentier

  4. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurochirurgie, Hôpital Beaujon, 92110, Clichy, France

    Thierry Faillot

  5. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de neurochirurgie, Hôpital Lariboisière, 75010, Paris, France

    Emmanuel Mandonnet

  6. Service de radiothérapie, IRHE, Hôpital Avicenne, 93009, Bobigny, France

    Christine Levy

Authors
  1. Antoine Kourilsky
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  2. Guillaume Bertrand
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  3. Renata Ursu
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  4. Jennifer Doridam
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  5. Ciprian Barlog
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  6. Thierry Faillot
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  7. Emmanuel Mandonnet
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  8. Catherine Belin
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  9. Christine Levy
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  10. Antoine F. Carpentier
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Corresponding author

Correspondence to Antoine F. Carpentier.

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Conflicts of interest

Antoine Carpentier was consultant for Roche in 2013–2014.

Ethical standards

This retrospective study has been approved by the institutional review board (Comité de Protection des Personnes Ile-de-France X) and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Kourilsky, A., Bertrand, G., Ursu, R. et al. Impact of Angiotensin-II receptor blockers on vasogenic edema in glioblastoma patients. J Neurol 263, 524–530 (2016). https://doi.org/10.1007/s00415-015-8016-9

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  • DOI: https://doi.org/10.1007/s00415-015-8016-9

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