title: Prolonged administration of adjuvant temozolomide improves survival in adult patients with glioblastoma.
abstract: BACKGROUND
  Radiotherapy with concomitant and adjuvant temozolomide (six cycles) is the standard treatment after surgery in glioblastoma patients. Few studies have assessed the impact of additional cycles of temozolomide on survival.
  
  
  METHODS
  We conducted a bi-centric retrospective study comparing survival and toxicity according to the number of cycles of adjuvant temozolomide.
  
  
  RESULTS
  Fifty-eight patients were included. All patients received radiotherapy with concomitant temozolomide. Thirty-eight patients received six cycles, while 20 received nine or more (median=14) cycles. The risk of recurrence was significantly higher in the group receiving six cycles compared to the other group. Prolonged treatment improved progression-free survival (p=0.03) and overall survival (p=0.01) in multivariate analysis without a significant increase in toxicity.
  
  
  CONCLUSIONS
  Prolonged administration of temozolomide seems to improve progression-free and overall survival, without increased toxicity. Prospective studies in larger populations are needed to better-define the population to whom it can be proposed and its optimal duration.
authors.affiliation: Neuro-oncology Unit, Department of Neurology, Centre Hospitalier Universitaire, 29 Avenue du Maréchal Lattre de Tassigny, Nancy, 54035 Cedex, France. a.darlix@gmail.com
authors.forename: Amélie
authors.initials: A
authors.lastname: Darlix
authors.forename: Cédric
authors.initials: C
authors.lastname: Baumann
authors.forename: Véronique
authors.initials: V
authors.lastname: Lorgis
authors.forename: François
authors.initials: F
authors.lastname: Ghiringhelli
authors.forename: Marie
authors.initials: M
authors.lastname: Blonski
authors.forename: Bruno
authors.initials: B
authors.lastname: Chauffert
authors.forename: Sonia
authors.initials: S
authors.lastname: Zouaoui
authors.forename: Catherine
authors.initials: C
authors.lastname: Pinelli
authors.forename: Fabien
authors.initials: F
authors.lastname: Rech
authors.forename: Patrick
authors.initials: P
authors.lastname: Beauchesne
authors.forename: Luc
authors.initials: L
authors.lastname: Taillandier
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D000077204:Temozolomide; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: Glioblastoma; prolonged adjuvant therapy; radiochemotherapy; temozolomide