| dc.description.abstracteng | Background: The current standard for newly diagnosed glioblastoma consists of surgical resection followed by combined chemotherapy and radiotherapy as well as adjuvant chemotherapy with temozolomide for 6 cycles. Many centres continue temozolomide after 6 cycles. This retrospective study compares adjuvant temozolomide for 6 cycles with continued temozolomide in terms of progression free and overall survival.
Methods: Patients were eligible, if they underwent surgery as well as radiotherapy (2Gy per day for 5 days a week, up to 60Gy) combined with daily temozolomide (75mg per m2/BSA), completed 6 cycles of temozolomide (150-200mg m2/BSA, 5 of 28 days) and had no signs of progressive disease on MRI. Respectively, patients who continued temozolomide were eligble if they completed 7 cycles temozolomide and showed no signs of progressive disease.
Results: A total of 51 patients were included. 12 patients received 6 cycles of temozolomide (control group). 39 patients continued temozolomide (7 – 47 cycles, median 15,3 cycles). Progression free survival was 3,6 months for the control group, compared to 8,8 months for the group of continued therapy (p=0,009, logrank test). Overall survival was 13,9 months for the control group, compared to 20,3 months (p=0,04, logrank test).
Discussion: Continuing temozolomide in this study shows a significant benefit for progression free and overall survival. Feasibility of long term temozolomide has been proved before, and stopping after 6 cycles seems arbitrary, but continuing would be an off-label use. Also, patient numbers in this study are limited, so further investigations should be performed.
Conclusion: Continuing adjuvant temozolomide after 6 cycles in patients with newly diagnosed glioblastoma shows a significant benefit in progression free and overall survival. Due to small patient numbers and continuing temozolomide being an off-label use, further investigations should be performed. | de |