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Long-term outcomes of concomitant chemoradiotherapy with temozolomide for newly diagnosed glioblastoma patients: A single-center analysis.

Authors
 Tae Hoon Roh  ;  Hun Ho Park  ;  Seok-Gu Kang  ;  Ju Hyung Moon  ;  Eui Hyun Kim  ;  Chang-Ki Hong  ;  Sung Soo Ahn  ;  Hye Jin Choi  ;  Jaeho Cho  ;  Se Hoon Kim  ;  Seung Koo Lee  ;  Dong Seok Kim  ;  Sun Ho Kim  ;  Chang-Ok Suh  ;  Kyu Sung Lee  ;  Jong Hee Chang 
Citation
 Medicine, Vol.96(27) : e7422, 2017 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents, Alkylating/therapeutic use ; Brain Neoplasms/diagnosis ; Brain Neoplasms/genetics ; Brain Neoplasms/metabolism ; Brain Neoplasms/therapy ; Chemoradiotherapy ; DNA Methylation ; DNA Modification Methylases/genetics ; DNA Modification Methylases/metabolism ; DNA Repair Enzymes/genetics ; DNA Repair Enzymes/metabolism ; Dacarbazine/analogs & derivatives ; Dacarbazine/therapeutic use ; Disease-Free Survival ; Female ; Follow-Up Studies ; Glioblastoma/diagnosis ; Glioblastoma/genetics ; Glioblastoma/metabolism ; Glioblastoma/therapy ; Humans ; Male ; Middle Aged ; Prognosis ; Promoter Regions, Genetic ; Retrospective Studies ; Treatment Outcome ; Tumor Suppressor Proteins/genetics ; Tumor Suppressor Proteins/metabolism ; Young Adult
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
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161419
DOI
10.1097/MD.0000000000007422
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강석구(Kang, Seok Gu) ; 김동석(Kim, Dong Seok) ; 김선호(Kim, Sun Ho) ; 김세훈(Kim, Se Hoon) ; 김의현(Kim, Eui Hyun) ; 문주형(Moon, Ju Hyung) ; 박현호(Park, Hun Ho) ; 서창옥(Suh, Chang Ok) ; 안성수(Ahn, Sung Soo) ; 이규성(Lee, Kyu Sung) ; 이승구(Lee, Seung Koo) ; 장종희(Chang, Jong Hee) ; 조재호(Cho, Jae Ho) ; 최혜진(Choi, Hye Jin) ; 홍창기(Hong, Chang Ki)
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