title: [Randomized controlled study of limited margins IMRT and temozolomide chemotherapy in patients with malignant glioma].
abstract: OBJECTIVE
  To evaluate the efficacy of limited margins intensity-modulated radiotherapy (IMRT) with temozolomide chemotherapy in patients with malignant glioma, and explore the prognostic factors of malignant glioma.
  
  
  METHODS
  A total of 33 whole-resected patients, 14 partial-resected patients and 3 biopsied patients were randomly divided into limited margins group and routine margins group. The patients were treated with IMRT and temozolomide concurrent chemotherapy, subsequently adjuvant chemotherapy. Then all the patients were evaluated 2 months later after concurrent chemoradiotherapy. Progression-free survival in 1 year (PFS-1), progress free survival rate in 1 year (PFSR-1) and 1 year survival rate (SR-1) were recorded.All the possible prognostic factors were analyzed.
  
  
  RESULTS
  Routine margins group: complete response (CR) 19, partial response (PR) 2, stable disease (SD) 2, progressive disease (PD) 2; Limited margins group: CR 16, PR 6, SD 1, PD 2. Mean PFS-1 of the two groups were 11.64 and 11.36 months, respectively. PFSR-1 were 84% in routine margins group and 80% in limited margins group. SR-1 of two groups were both 100%. Surgery results and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status were correlated with immediate-term prognosis by either univariate or multivariate analysis. Both surgery results and immediate-term prognosis were relevant factors to PFS-1. Progression sites in two groups had no statistical difference by analysis.
  
  
  CONCLUSIONS
  Both groups gained favorable results, and limited margins doesn't increase local failures. Surgery results are important prognostic factors to immediate-term prognosis and PFS-1.
authors.affiliation: Department of Radiotherapy, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Wenxue
authors.initials: W
authors.lastname: Zhang
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.forename: Yongzhen
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China, Email:ydenny@yahoo.com.
authors.forename: Xuejun
authors.initials: X
authors.lastname: Yang
mesh_terms: D018906:Antineoplastic Agents, Alkylating; D001932:Brain Neoplasms; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D015254:DNA Modification Methylases; D045643:DNA Repair Enzymes; D003606:Dacarbazine / Q000031:analogs & derivatives; D018450:Disease Progression; D018572:Disease-Free Survival; D005909:Glioblastoma; D005910:Glioma; D006801:Humans; D011379:Prognosis; D011401:Promoter Regions, Genetic; D050397:Radiotherapy, Intensity-Modulated; D012074:Remission Induction; D015996:Survival Rate; D000077204:Temozolomide; D025521:Tumor Suppressor Proteins
chemical_list: D018906:Antineoplastic Agents, Alkylating; D025521:Tumor Suppressor Proteins; D003606:Dacarbazine; D015254:DNA Modification Methylases; C515491:MGMT protein, human; D045643:DNA Repair Enzymes; D000077204:Temozolomide