1. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma
- Author
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Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJB, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO, Van Den Weyngaert D, Kaendler S, Krauseneck P, Vinolas N, Villa S, Wurm RE, Maillot MHB, Spagnolli F, Kantor G, Malhaire JP, Renard L, De Witte O, Scandolaro L, Vecht CJ, Maingon P, Lutterbach J, Kobierska A, Bolla M, Souchon R, Mitine C, Tzuk-Shina T, Kuten A, Haferkamp G, de Greve J, Priou F, Menten J, Rutten I, Clavere P, Malmstrom A, Jancar B, Newlands E, Pigott K, Twijnstra A, Chinot O, Reni M, Boiardi A, Fabbro M, Campone M, Bozzino J, Frenay M, Gijtenbeek J, Delattre JY, De Paula U, Hanzen C, Pavanato G, Schraub S, Pfeffer R, Soffietti R, Kortmann RD, Taphoorn M, Torrecilla JL, Grisold W, Huget P, Forsyth P, Fulton D, Kirby S, Wong R, Fenton D, Cairncross G, Whitlock P, Burdette-Radoux S, Gertler S, Saunders S, Laing K, Siddiqui J, Martin LA, Gulavita S, Perry J, Mason W, Thiessen B, Pai H, Alam ZY, Eisenstat D, Mingrone W, Hofer S, Pesce G, Dietrich PY, Thum P, Baumert B, Ryan G, Stupp, R, Mason, Wp, van den Bent, Mj, Weller, M, Fisher, B, Taphoorn, Mjb, Belanger, K, Brandes, Aa, Marosi, C, Bogdahn, U, Curschmann, J, Janzer, Rc, Ludwin, Sk, Gorlia, T, Allgeier, A, Lacombe, D, Cairncross, Jg, Eisenhauer, E, Mirimanoff, Ro, Van Den Weyngaert, D, Kaendler, S, Krauseneck, P, Vinolas, N, Villa, S, Wurm, Re, Maillot, Mhb, Spagnolli, F, Kantor, G, Malhaire, Jp, Renard, L, De Witte, O, Scandolaro, L, Vecht, Cj, Maingon, P, Lutterbach, J, Kobierska, A, Bolla, M, Souchon, R, Mitine, C, Tzuk-Shina, T, Kuten, A, Haferkamp, G, de Greve, J, Priou, F, Menten, J, Rutten, I, Clavere, P, Malmstrom, A, Jancar, B, Newlands, E, Pigott, K, Twijnstra, A, Chinot, O, Reni, M, Boiardi, A, Fabbro, M, Campone, M, Bozzino, J, Frenay, M, Gijtenbeek, J, Delattre, Jy, De Paula, U, Hanzen, C, Pavanato, G, Schraub, S, Pfeffer, R, Soffietti, R, Kortmann, Rd, Taphoorn, M, Torrecilla, Jl, Grisold, W, Huget, P, Forsyth, P, Fulton, D, Kirby, S, Wong, R, Fenton, D, Cairncross, G, Whitlock, P, Burdette-Radoux, S, Gertler, S, Saunders, S, Laing, K, Siddiqui, J, Martin, La, Gulavita, S, Perry, J, Mason, W, Thiessen, B, Pai, H, Alam, Zy, Eisenstat, D, Mingrone, W, Hofer, S, Pesce, G, Dietrich, Py, Thum, P, Baumert, B, Ryan, G, Neurology, and Plastic and Reconstructive Surgery and Hand Surgery
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Adrenal Cortex Hormones ,Adrenal Cortex Hormones/therapeutic use Adult Aged Antineoplastic Agents, Alkylating/adverse effects/*therapeutic use Brain Neoplasms/*drug therapy/mortality/*radiotherapy Chemotherapy, Adjuvant Dacarbazine/adverse effects/*analogs & derivatives/*therapeutic use Disease Progression Female Glioblastoma/*drug therapy/mortality/*radiotherapy Humans Male Middle Aged Proportional Hazards Models Radiotherapy, Computer-Assisted/adverse effects Survival Analysis ,medicine ,Temozolomide ,Humans ,Survival rate ,Pseudoprogression ,Antineoplastic Agents, Alkylating ,Aged ,Proportional Hazards Models ,business.industry ,Brain Neoplasms ,Hazard ratio ,General Medicine ,Middle Aged ,Debulking ,medicine.disease ,Survival Analysis ,Radiotherapy, Computer-Assisted ,Surgery ,Radiation therapy ,Dacarbazine ,Chemotherapy, Adjuvant ,Concomitant ,Disease Progression ,Female ,business ,Glioblastoma ,medicine.drug ,Anaplastic astrocytoma - Abstract
BACKGROUND: Glioblastoma, the most common primary brain tumor in adults, is usually rapidly fatal. The current standard of care for newly diagnosed glioblastoma is surgical resection to the extent feasible, followed by adjuvant radiotherapy. In this trial we compared radiotherapy alone with radiotherapy plus temozolomide, given concomitantly with and after radiotherapy, in terms of efficacy and safety. METHODS: Patients with newly diagnosed, histologically confirmed glioblastoma were randomly assigned to receive radiotherapy alone (fractionated focal irradiation in daily fractions of 2 Gy given 5 days per week for 6 weeks, for a total of 60 Gy) or radiotherapy plus continuous daily temozolomide (75 mg per square meter of body-surface area per day, 7 days per week from the first to the last day of radiotherapy), followed by six cycles of adjuvant temozolomide (150 to 200 mg per square meter for 5 days during each 28-day cycle). The primary end point was overall survival. RESULTS: A total of 573 patients from 85 centers underwent randomization. The median age was 56 years, and 84 percent of patients had undergone debulking surgery. At a median follow-up of 28 months, the median survival was 14.6 months with radiotherapy plus temozolomide and 12.1 months with radiotherapy alone. The unadjusted hazard ratio for death in the radiotherapy-plus-temozolomide group was 0.63 (95 percent confidence interval, 0.52 to 0.75; P
- Published
- 2005
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