title: [Outcomes of application of modern first-line chemotherapy regimens in complex treatment of glioblastoma patients].
abstract: To describe a procedure and outcomes of comprehensive first-line treatment in glioblastoma patients.
  
  
  
  We analyzed 107 glioblastoma patients operated on in 2010-2011. Seventy five patients underwent combined chemoradiotherapy (CRT) with simultaneous administration of 75 mg/m2 temozolomide (TMZ), followed by chemotherapy with 200 mg/m2 TMZ for 5 days, every 28 days. Separately, we examined 32 patients with large tumors who received alternative treatments.
  
  
  
  The median time to progression was 11.7 months in the study group and 7.2 and 8.1 months in groups of alternative therapy. The one-year progression-free survival rate was 37%. Overall survival was 29.2 months.
  
  
  
  The chemoradiotherapy regimen involving TMZ followed by one-year TMZ monotherapy is the appropriate treatment for patients with resected glioblastoma. With this approach, no tumor progression occurs in one third of patients during the first year. A careful study of the clinical and radiological findings in the course of treatment makes it possible to achieve the maximum efficacy, avoid unreasonably early switch to second-line therapy, and timely detect tumor recurrence signs. The Response Assessment in Neuro-Oncology (RANO) criteria should be used for assessment of MRI detected changes in the tumor size. The rates of overall and recurrence-free survival were significantly lower in patients with inoperable or partially resected tumors. The applied approaches provide only a slight advantage in control of tumor growth, which necessitates searching for more efficient treatment options for these patients. One of the approaches may be addition of bevacizumab to the first-line therapy regimen.
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: O V
authors.initials: OV
authors.lastname: Absalyamova
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: G L
authors.initials: GL
authors.lastname: Kobyakov
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: M V
authors.initials: MV
authors.lastname: Ryzhova
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A A
authors.initials: AA
authors.lastname: Poddubskiy
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: M V
authors.initials: MV
authors.lastname: Inozemtseva
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: K S
authors.initials: KS
authors.lastname: Lodygina
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D024221:Antineoplastic Protocols; D000068258:Bevacizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000628:therapy*; D059248:Chemoradiotherapy; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D005909:Glioblastoma / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077204:Temozolomide
chemical_list: D000970:Antineoplastic Agents; D000068258:Bevacizumab; D003606:Dacarbazine; D000077204:Temozolomide