Correlation between Response Assessment in Neuro-Oncology (RANO) Criteria and Clinical Outcome in Patients with Brain Tumor

Abstract

Response assessment in neuro-oncology (RANO) criteria was established to improve the assessment of tumor response and provide guidance on the assessment of response and endpoints in neuro-oncology clinical trials. Neurologic assessment in neuro-oncology (NANO) scale is an instrument used for assessing neurological function objectively and practical in intracranial tumor patients. This study aimed to determine the association between RANO criteria with clinical outcome measured by NANO scale in intracranial tumors patients. There were 36 intracranial tumor patients that were studied in Haji Adam Malik General Hospital Medan. The RANO criteria were obtained by comparing the size of the enhanced lesion using Computed Tomography (CT) scan within an interval of a minimum of four weeks of treatment. NANO scale is a quantifiable evaluation of nine relevant neurologic domains based on examination. The NANO scale included gait, strength, ataxia, sensation, visual fields, facial strength, language, level of consciousness, and behavior as assessed domains from the medical record. We analyzed the correlation between the RANO criteria and NANO scale score using the Spearman correlation test. There were 19 males and 17 females. The mean age was 45.22±9.68 years. There were 20 patients (55.6%) with meningioma, 11 patients (30.6%) with glioma, 3 patients (8.3%) with brain metastase, and 2 patients (5.6%) with craniopharyngioma. The mean NANO scale scores for stable and progressive RANO criteria were 4.29±2.02 and 7.88±2.99, respectively. There was a significant correlation between RANO criteria and NANO scale score in patients with intracranial tumor (r = 0.468; p = 0.004). Patients with stable RANO had lower NANO scale scores indicating better response to treatment and clinical outcome.