Radiotherapy followed by adjuvant temozolomide treatment of malignant glioma.
BACKGROUND
Malignant gliomas are the most frequent primary brain tumors in adults. In this clinical trial, we compared the therapeutic advantage of radiotherapy followed by temozolomide vs radiotherapy alone for the malignant glioma patients.


METHODS
In the 4-year retrospective study, 31 patients with histologically confirmed malignant gliomas, in which 10 patients received radiotherapy followed by temozolomide (group A) and 21 patients received radiotherapy alone (group B). The main end point of evaluation and comparison of 2 therapeutic trials was overall survival.


RESULTS
Two patients (6%) underwent biopsy, 19 patients (62%) underwent subtotal resection, and 10 patients (32%) underwent gross total resection. Mean overall survival was 30.44+/-2.41 months for radiotherapy followed by adjuvant temozolomide vs 17.95+/-4.27 months for radiotherapy alone (P=.007). No major adverse effects were observed.


CONCLUSIONS
Based on our study, the patients of malignant glioma treated with radiotherapy followed by temozolomide obtained a statistically significant better benefit of survival than those treated with radiotherapy alone. Temozolomide therapy was well tolerated by the patients. The larger series of patients and long-term follow-up of late toxic effects are needed for further confirmation.
Yang
Tzu-Ming
TM
Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung Hsein, Taiwan.
Wang
Hung-Chen
HC
Lin
Yu-Jun
YJ
Lin
Wei-Che
WC
Lu
Cheng-Hsien
CH
Chang
Wen-Neng
WN
Chang
Hsueh-Wen
HW
Ho
Jih-Tsun
JT
D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use*; D001706:Biopsy; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D016019:Survival Analysis; D000077204:Temozolomide; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide