Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea.
- Author:
Byung Sup KIM
1
;
Ho Jun SEOL
;
Do Hyun NAM
;
Chul Kee PARK
;
Il Han KIM
;
Tae Min KIM
;
Jeong Hoon KIM
;
Young Hyun CHO
;
Sang Min YOON
;
Jong Hee CHANG
;
Seok Gu KANG
;
Eui Hyun KIM
;
Chang Ok SUH
;
Tae Young JUNG
;
Kyung Hwa LEE
;
Chae Yong KIM
;
In Ah KIM
;
Chang Ki HONG
;
Heon YOO
;
Jin Hee KIM
;
Shin Hyuk KANG
;
Min Kyu KANG
;
Eun Young KIM
;
Sun Hwan KIM
;
Dong Sup CHUNG
;
Sun Chul HWANG
;
Joon Ho SONG
;
Sung Jin CHO
;
Sun Il LEE
;
Youn Soo LEE
;
Kook Jin AHN
;
Se Hoon KIM
;
Do Hun LIM
;
Ho Shin GWAK
;
Se Hoon LEE
;
Yong Kil HONG
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Glioblastoma; Temozolomide; MGMT; Chemoradiotherapy
- MeSH: Biopsy; Chemoradiotherapy*; Disease-Free Survival; Follow-Up Studies; Glioblastoma*; Humans; Korea*; Methylation; Radiotherapy; Retrospective Studies*; Survival Rate
- From:Cancer Research and Treatment 2017;49(1):193-203
- CountryRepublic of Korea
- Language:English
- 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. 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. 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 O6-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. 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.
