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

J Neurol. 2016 Mar;263(3):524-30. doi: 10.1007/s00415-015-8016-9. Epub 2016 Jan 11.

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.

Keywords: ADC; Angiotensin receptor blockers; Edema; FLAIR; Glioblastoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Brain Edema / diagnostic imaging
  • Brain Edema / drug therapy*
  • Brain Edema / etiology*
  • Brain Mapping
  • Brain Neoplasms / complications*
  • Brain Neoplasms / diagnostic imaging
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Glioblastoma / complications*
  • Glioblastoma / diagnostic imaging
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Retrospective Studies
  • Statistics, Nonparametric

Substances

  • Angiotensin Receptor Antagonists