title: Combined temozolomide and radiation as an initial treatment for anaplastic glioma.
abstract: OBJECTIVE
  Combined temozolomide (TMZ) and radiation therapy (RT) is often used as initial treatment for anaplastic glioma. However, there is no prospective randomized data available that proves the efficacy of the combination for anaplastic glioma. In this retrospective study we aimed to compare the outcome of patients who had combined TMZ and RT with those who had RT alone for the initial treatment of anaplastic glioma in our centers.
  
  
  METHODS
  Patients with anaplastic astrocytoma or oligoastrocytoma treated at our centers between 2000 and 2010 were reviewed. Only patients who received initial RT or concurrent TMZ and RT (TMZ-RT) were included.
  
  
  RESULTS
  Of 62 patients, 55 were less than 66-years old; 36 (58.1%) had a tumor resection and 26 had a biopsy only. An oligodendroglial component in their tumor histology was present in 21 patients (33.9%). At a median follow up of 20.7 months for all patients, median progression-free survival was similar for the two treatment groups (RT alone: 16.7 months (95% CI 9.4, 34.8 months) versus TMZ-RT: 14.8 months (95% CI 8.6, 28.6 months, P = NS). Median overall survival was 27.4 months (95% CI 10.6, not estimable [NE] months) for patients who had RT alone and 34.1 months (95% CI 19.8, 42.1 months) for those who had TMZ-RT.
  
  
  CONCLUSIONS
  No significant benefit of combined TMZ with RT compared to RT alone was observed as the initial treatment of anaplastic glioma. Prospective randomized trials are needed to evaluate the optimal treatment for this disease.
authors.affiliation: Department of Medical Oncology, National Cancer Centre, Singapore. tham.c.k@nccs.com.sg
authors.forename: Chee Kian
authors.initials: CK
authors.lastname: Tham
authors.forename: Siew Ju
authors.initials: SJ
authors.lastname: See
authors.forename: Sze Huey
authors.initials: SH
authors.lastname: Tan
authors.forename: Keith Hsiu Chin
authors.initials: KH
authors.lastname: Lim
authors.forename: Wai Hoe
authors.initials: WH
authors.lastname: Ng
authors.forename: John
authors.initials: J
authors.lastname: Thomas
authors.forename: Dawn Qingqing
authors.initials: DQ
authors.lastname: Chong
authors.forename: Eu Tiong
authors.initials: ET
authors.lastname: Chua
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D059248:Chemoradiotherapy; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D015996:Survival Rate; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: anaplastic glioma; radiation; temozolomide