title: High-dose radiotherapy to 78 Gy with or without temozolomide for high grade gliomas.
abstract: OBJECTIVE
  To describe outcomes associated with high-dose radiotherapy with and without temozolomide for high grade central nervous system (CNS) neoplasms.
  
  
  METHODS
  Retrospective chart review of 60 patients diagnosed with malignant glioma treated with > or =70 Gy radiotherapy.
  
  
  RESULTS
  Median age at diagnosis was 52 years, and 52 patients had astrocytomas (38 glioblastomas). Median prescribed radiotherapy dose was 78 Gy (range 70-80), and 29 patients received concurrent temozolomide. Eighty-six percent completed the planned course treatment. Three patients experienced RTOG grade 3 acute CNS toxicity; late brain necrosis was suspected in four patients. Overall median survival was 13 months (range 2-83). Within glioblastoma patients, temozolomide provided a statistically significant survival improvement over no chemotherapy (median survival 12.7 vs. 7.5 months; P = 0.0058).
  
  
  CONCLUSIONS
  High dose conformal radiotherapy to > or =70 Gy with chemotherapy for high-grade CNS neoplasms appears safe but survival remains suboptimal. Within glioblastoma patients, temozolomide provided statistically significant survival improvement over no chemotherapy.
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Watkins
authors.forename: David T
authors.initials: DT
authors.lastname: Marshall
authors.forename: Sunil
authors.initials: S
authors.lastname: Patel
authors.forename: Pierre
authors.initials: P
authors.lastname: Giglio
authors.forename: Amy E
authors.initials: AE
authors.lastname: Herrin
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Garrett-Mayer
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Jenrette
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004307:Dose-Response Relationship, Radiation; D005910:Glioma / Q000473:pathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D011829:Radiation Dosage; D011878:Radiotherapy / Q000379:methods*; D012189:Retrospective Studies; D000077204:Temozolomide; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide