3-D conformal radiotherapy with concomitant and adjuvant temozolomide for patients with glioblastoma multiforme and evaluation of prognostic factors

Radiol Oncol. 2011 Sep;45(3):213-9. doi: 10.2478/v10019-011-0019-2. Epub 2011 Jul 20.

Abstract

Background: The aim of the retrospective study was to evaluate the outcome and prognostic factors of newly diagnosed glioblastoma patients who received 3-D conformal radiotherapy (RT) combined with concomitant and/or adjuvant temozalamide (TMZ) postoperatively.

Patients and methods: Fifty patients with glioblastoma multiforme were treated with 3-D conformal RT combined with concomitant and/or adjuvant TMZ postoperatively. Median age was 57 years (range, 12-79) and median Karnofsky performance status (KPS) was 70 (range, 40-100). A multivariate Cox regression model was used to test the effect of age, sex, KPS, extent of surgery, tumour dimension (<5cm vs. ≥5cm), full dose RT (≥60 Gy vs. <60 Gy), concurrent TMZ and adjuvant TMZ treatment (adjuvant therapy plus 6 cycles of TMZ group versus <6 cycles of TMZ group) on the overall survival.

Results: The median follow up time was 10 months (range 3-42). One- and 2-year overall survival rates were 46% and 20%, respectively. The prognostic factors important for the overall survival were a full dose RT (≥60 Gy) (p=0.005) and the application of adjuvant TMZ for 6 cycles (p=0.009).

Conclusions: The results of our study confirm the efficiency of RT plus concomitant and adjuvant TMZ, with an acceptable toxicity in patients. We suggest that at least 6 cycles of adjuvant TMZ should be administered to obtain a benefit from the adjuvant treatment.

Keywords: conformal radiotherapy; glioblastoma multiforme; prognostic factors; temozolomide.