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Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea

 Byung Sup Kim  ;  Ho Jun Seol  ;  Do-Hyun Nam  ;  Chul-Kee Park  ;  Il Han Kim  ;  Tae Min Kim  ;  Jeong Hoon Kim  ;  Young Hyun Cho  ;  Sang Min Yoon  ;  Jong Hee Chang  ;  Seok-Gu Kang  ;  Eui Hyun Kim  ;  Chang-Ok Suh  ;  Tae-Young Jung  ;  Kyung-Hwa Lee  ;  Chae-Yong Kim  ;  In Ah Kim  ;  Chang-Ki Hong  ;  Heon Yoo  ;  Jin Hee Kim  ;  Shin-Hyuk Kang  ;  Min Kyu Kang  ;  Eun-Young Kim  ;  Sun-Hwan Kim  ;  Dong-Sup Chung  ;  Sun-Chul Hwang  ;  Joon-Ho Song  ;  Sung Jin Cho  ;  Sun-Il Lee  ;  Youn-Soo Lee  ;  Kook-Jin Ahn  ;  Se Hoon Kim  ;  Do Hun Lim  ;  Ho-Shin Gwak  ;  Se-Hoon Lee  ;  Yong-Kil Hong 
 CANCER RESEARCH AND TREATMENT, Vol.49(1) : 193-203, 2017 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents, Alkylating/therapeutic use ; Biopsy ; Brain Neoplasms/diagnosis ; Brain Neoplasms/mortality ; Brain Neoplasms/therapy* ; Chemoradiotherapy*/adverse effects ; Chemoradiotherapy*/methods ; Combined Modality Therapy ; Dacarbazine/analogs & derivatives ; Dacarbazine/therapeutic use ; Disease Progression ; Female ; Glioblastoma/diagnosis ; Glioblastoma/mortality ; Glioblastoma/therapy* ; Humans ; Kaplan-Meier Estimate ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Treatment Outcome ; Young Adult
Chemoradiotherapy ; Glioblastoma ; MGMT ; Temozolomide
PURPOSE: The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample.

MATERIALS AND METHODS: A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively.

RESULTS: After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients, respectively. The methylation status of O6-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period.

CONCLUSION: Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Suh, Chang Ok(서창옥)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Hong, Chang Ki(홍창기) ORCID logo https://orcid.org/0000-0002-2761-0373
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