title: [Benefit of a prolonged adjuvant treatment with temozolomide for the management of patients with glioblastoma].
abstract: OBJECTIVE
  Temozolomide has significantly improved the outcome of patients with glioblastoma. However, the optimal duration of continuation treatment after chemoradiation remains uncertain. This retrospective analysis aims at assessing the feasibility, the tolerance, and the potential benefit of prolonging adjuvant temozolomide more than six months, which is the reference protocol.
  
  
  METHODS
  Forty-six patients were included in the analysis. Median age at diagnosis was 61 years old (range 40 to 77). Forty-five patients received a conformal external beam radiation with concurrent temozolomide-based chemotherapy. Then, 37 patients received adjuvant chemotherapy with temozolomide. The treatment was continued until progression or toxicity.
  
  
  RESULTS
  During the adjuvant phase, no treatment discontinuation for toxicity was necessary. Eight patients required dose adaptation because of toxicity. Thirty-two patients presented tumor progression during the adjuvant phase. Overall median survival was 12.3 months (range 11-13.2 months) and progression-free survival (PFS) was 7.6 months (range 5.6-9.6 months).
  
  
  CONCLUSIONS
  These results suggest feasibility of delivering temozolomide beyond the six months of the standard protocol, with mild toxicity and survival data at least comparable to those from literature. Prospective assessments are ongoing.
authors: Département de radiothérapie, institut de cancérologie de la Loire, Saint-Priest-en-Jarez, France.
authors: N
authors: N
authors: Malkoun
authors: M-J
authors: MJ
authors: Fotso
authors: L
authors: L
authors: Cartier
authors: F
authors: F
authors: Forest
authors: P
authors: P
authors: Auberdiac
authors: C
authors: C
authors: Chargari
authors: J
authors: J
authors: Thorin
authors: C
authors: C
authors: Pacaut
authors: M
authors: M
authors: Peoc'h
authors: C
authors: C
authors: Nuti
authors: T
authors: T
authors: Schmitt
authors: N
authors: N
authors: Magné
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods*; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide