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Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea.
- Source :
-
Cancer research and treatment [Cancer Res Treat] 2017 Jan; Vol. 49 (1), pp. 193-203. Date of Electronic Publication: 2016 Jun 27. - Publication Year :
- 2017
-
Abstract
- Purpose: The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample.<br />Materials and Methods: A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively.<br />Results: After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients, respectively. The methylation status of O <superscript>6</superscript> -methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period.<br />Conclusion: Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.<br />Competing Interests: relevant to this article was not reported.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Alkylating therapeutic use
Biopsy
Brain Neoplasms diagnosis
Brain Neoplasms mortality
Combined Modality Therapy
Dacarbazine analogs & derivatives
Dacarbazine therapeutic use
Disease Progression
Female
Glioblastoma diagnosis
Glioblastoma mortality
Humans
Kaplan-Meier Estimate
Magnetic Resonance Imaging methods
Male
Middle Aged
Temozolomide
Treatment Outcome
Young Adult
Brain Neoplasms therapy
Chemoradiotherapy adverse effects
Chemoradiotherapy methods
Glioblastoma therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2005-9256
- Volume :
- 49
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cancer research and treatment
- Publication Type :
- Academic Journal
- Accession number :
- 27384161
- Full Text :
- https://doi.org/10.4143/crt.2015.473