title: Effectiveness of adjuvant temozolomide treatment in patients with glioblastoma.
abstract: OBJECTIVE
  To examine whether adjuvant temozolomide treatment improved glioblastoma patients` survival in a large Canadian cohort.
  
  
  METHODS
  We retrospectively studied 364 glioblastoma patients who received different modalities of treatment in 2 Canadian tertiary care centers in Edmonton and Halifax, Canada, between January 2000 and December 2006. The primary outcome was survival following the treatment protocol.
  
  
  RESULTS
  The following variables were associated with an increased risk of death: The hazard risk (HR) of on-gross total resection was 0.50 (95% confidence interval [CI]: 0.39-0.64). The HR for the surgery-only group was 5.2 (95% CI: 3.85-7.06). The standard treatment group (surgery, radiation therapy [RT], and temozolomide) had an HR of 0.52 (95% CI: 0.37-0.74). The HR for patients who presented with seizure or whose presentation included seizures was 0.88 (95% CI: 0.55-0.89). Patient entry into trials had an HR of 0.74 (95% CI: 0.57-0.96). Finally, the HR for age was 1.02 (95% CI: 1.01-1.03) for every extra year.
  
  
  CONCLUSIONS
  Concomitant temozolomide with RT and surgery was associated with longer survival compared with RT with surgery alone. We also found that younger age, surgical resection, seizure presence, and entry into trials are important prognostic factors for longer survival.
authors.affiliation: Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, PO Box 641, Abha, Kingdom of Saudi Arabia. Tel. +966 541499966. Fax. +966 (17) 2412807. E-mail: ialnaami@ualberta.ca / ialnaami@gmail.com.
authors.forename: Ibrahim M
authors.initials: IM
authors.lastname: Alnaami
authors.forename: Saleem K
authors.initials: SK
authors.lastname: Al-Nuaimi
authors.forename: Ambikaipakan
authors.initials: A
authors.lastname: Senthilselvan
authors.forename: Albert D
authors.initials: AD
authors.lastname: Murtha
authors.forename: Simon
authors.initials: S
authors.lastname: Walling
authors.forename: Vivek
authors.initials: V
authors.lastname: Mehta
authors.forename: Sita
authors.initials: S
authors.lastname: Gourishankar
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000401:mortality / Q000628:therapy*; D002170:Canada; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011878:Radiotherapy; D012189:Retrospective Studies; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D003606:Dacarbazine; D000077204:Temozolomide