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Long-term outcomes of concomitant chemoradiotherapy with temozolomide for newly diagnosed glioblastoma patients: A single-center analysis.
- Source :
-
Medicine [Medicine (Baltimore)] 2017 Jul; Vol. 96 (27), pp. e7422. - Publication Year :
- 2017
-
Abstract
- The present study analyzed outcomes of surgery followed by concomitant chemoradiotherapy (CCRT) with temozolomide (TMZ) in patients with newly diagnosed glioblastoma (GBM) at a single institution. Outcomes were retrospectively reviewed in 252 consecutive patients with newly diagnosed GBM who underwent surgery followed by CCRT with TMZ at the authors' institution between 2005 and 2013. At initial operation, 126 (50.0%), 55 (21.8%), 45 (17.9%), and 26 (10.3%) patients underwent gross total resection (GTR), subtotal resection, partial resection (PR), and biopsy, respectively. Their median overall survival (OS) was 20.8 months (95% confidence interval [CI] 17.7-23.9 months) and their median progression-free survival was 12.7 months (95% CI 11.2-14.2 months). The O-methylguanine-DNA methyltransferase (MGMT) promoter was methylated in 78 (34.1%) of the 229 patients assayed, and an isocitrate dehydrogenase 1 mutation was detected in 7 (6.6%) of the 106 patients analyzed. Univariate analyses showed that patient age, involvement of eloquent areas, involvement of the subventricular zone, presence of leptomeningeal seeding, Karnofsky Performance Status, extent of resection (EOR), MGMT promoter methylation, and presence of an oligodendroglioma component were prognostic of OS. Multivariate analysis showed that age, involvement of eloquent areas, presence of leptomeningeal seeding, EOR, and MGMT promoter methylation were significantly predictive of survival. OS in patients with GBM who undergo surgery followed by CCRT with TMZ is enhanced by complete resection. Other factors significantly prognostic of OS include that age, involvement of eloquent areas, presence of leptomeningeal seeding, and MGMT promoter methylation.
- Subjects :
- Adult
Aged
Aged, 80 and over
Brain Neoplasms diagnosis
Brain Neoplasms genetics
Brain Neoplasms metabolism
DNA Methylation
DNA Modification Methylases genetics
DNA Modification Methylases metabolism
DNA Repair Enzymes genetics
DNA Repair Enzymes metabolism
Dacarbazine therapeutic use
Disease-Free Survival
Female
Follow-Up Studies
Glioblastoma diagnosis
Glioblastoma genetics
Glioblastoma metabolism
Humans
Male
Middle Aged
Prognosis
Promoter Regions, Genetic
Retrospective Studies
Temozolomide
Treatment Outcome
Tumor Suppressor Proteins genetics
Tumor Suppressor Proteins metabolism
Young Adult
Antineoplastic Agents, Alkylating therapeutic use
Brain Neoplasms therapy
Chemoradiotherapy
Dacarbazine analogs & derivatives
Glioblastoma therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1536-5964
- Volume :
- 96
- Issue :
- 27
- Database :
- MEDLINE
- Journal :
- Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28682902
- Full Text :
- https://doi.org/10.1097/MD.0000000000007422