title: Radiochemotherapy in patients with primary glioblastoma comparing two temozolomide dose regimens.
abstract: OBJECTIVE
  To evaluate toxicity and outcomes in patients with primary glioblastoma (GB) treated with postoperative radiochemotherapy (RCHT) with temozolomide (TMZ) comparing two dose regimens.
  
  
  METHODS
  A total of 160 patients with histologically confirmed GB were treated with postoperative RCHT with TMZ. Of the patients, 66 were female and 94 were male, with a median age of 60 years. After the primary diagnosis, a biopsy had been performed in 42 patients; a subtotal and total resection was conducted in 66 and 52 patients. Postoperative radiotherapy was applied with a median dose of 60 Gy with a median fractionation of 5 x 2Gy/week. Concomitant TMZ was prescribed at 50 mg/m(2) in 123 patients (Group A) and at 75 mg/m(2) in 37 patients (Group B). Patients were followed in 3-months intervals, with a median follow-up of 13 months.
  
  
  RESULTS
  Overall survival (OS) rates in Group A vs. Group B were 67% and 79% at 1 year and 43% vs. 49% at 2 years, respectively (p = 0.69). Progression-free survival was 49% vs. 54% at 1 year and 22% vs. 29% at 2 years (p = 0.31). Hematologic toxicity was not statistically significant over the 6-week RCHT period except for a significant decrease in platelets during Week 6 (p = 0.01) in Group B.
  
  
  CONCLUSIONS
  Overall survival seems to be comparable in both groups, although longer follow-up and a larger group of patients are needed to corroborate these results. Lower dosing of TMZ also is associated with a more beneficial toxicity profile.
authors.affiliation: Neuro-Radiation Oncology Research Group, Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany. Stephanie.Combs@med.uni-heidelberg.de
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Combs
authors.forename: Johanna
authors.initials: J
authors.lastname: Wagner
authors.forename: Marc
authors.initials: M
authors.lastname: Bischof
authors.forename: Thomas
authors.initials: T
authors.lastname: Welzel
authors.forename: Lutz
authors.initials: L
authors.lastname: Edler
authors.forename: Renate
authors.initials: R
authors.lastname: Rausch
authors.forename: Florian
authors.initials: F
authors.lastname: Wagner
authors.forename: Angelika
authors.initials: A
authors.lastname: Zabel-du Bois
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.forename: Daniela
authors.initials: D
authors.lastname: Schulz-Ertner
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000401:mortality* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005858:Germany / Q000453:epidemiology; D005909:Glioblastoma / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011878:Radiotherapy / Q000401:mortality*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide