title: Radiation combined with temozolomide contraindicated for young adults diagnosed with anaplastic glioma.
abstract: OBJECTIVE
  Age is a major prognostic factor for malignant gliomas. However, few studies have investigated the management of gliomas in young adults. We determined the role of survival and treatment in young adults with advanced gliomas in a large population from the Chinese Glioma Genome Atlas (CGGA).
  
  
  METHODS
  This study included 726 adults (age ≥ 18) with histologically proven anaplastic glioma or glioblastoma multiforme (GBM). The overall and progression-free survival was determined in young (age < 50) and older groups (age ≥ 50).
  
  
  RESULTS
  The study included an older group (OP) of 264 patients and a younger group (YP) of 462patients. In the OP group with GBM and anaplastic glioma, patients treated with RT combined with temozolomide (TMZ) manifested significantly longer OS and PFS compared with patients assigned to RT alone (P < 0.05). In contrast, the YP group diagnosed with anaplastic glioma failed to show any survival advantage with RT plus TMZ compared with RT alone.
  
  
  CONCLUSIONS
  We observed no survival benefit in young adults (age < 50) with anaplastic glioma when treated with TMZ combined with RT. Our findings warrant further investigation of younger patients diagnosed with anaplastic glioma treated with radiotherapy plus TMZ chemotherapy.
authors: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Pei
authors: P
authors: Yang
authors: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Chuanbao
authors: C
authors: Zhang
authors: Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors: Jinquan
authors: J
authors: Cai
authors: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Gan
authors: G
authors: You
authors: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Yinyan
authors: Y
authors: Wang
authors: Department of Radiation Therapy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Xiaoguang
authors: X
authors: Qiu
authors: Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
authors: Shouwei
authors: S
authors: Li
authors: Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
authors: Chenxing
authors: C
authors: Wu
authors: Department of Pathology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
authors: Kun
authors: K
authors: Yao
authors: Department of Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors: Wenbin
authors: W
authors: Li
authors: Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China.
authors: Xiaoxia
authors: X
authors: Peng
authors: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Wei
authors: W
authors: Zhang
authors: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.|Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China.
authors: Tao
authors: T
authors: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy / Q000009:adverse effects; D000075202:Contraindications; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D016019:Survival Analysis; D000077204:Temozolomide; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: high-grade glioma; radiation; survival; temozolomide; young adult