Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
Neuro Oncol. 2012 Sep;14(9):1178-84. doi: 10.1093/neuonc/nos153. Epub 2012 Aug 6.
The effect of temozolomide (TMZ) and radiotherapy (RT) in the treatment of glioblastoma multiforme (GBM) has been well documented in randomized controlled trials. Here we present our findings on the effect of TMZ added to RT at a population level. The Cancer Registry of Norway was searched for patients with a GBM diagnosis from January 1, 2000 to December 31, 2007. Subsequently, the prescriptions registered to these patients were obtained from the Norwegian Prescription Database. The data were analyzed according to era (pre-TMZ introduction or post-TMZ introduction) and according to treatment received. Furthermore, a matching procedure was utilized to reduce the bias between the RT + TMZ and RT alone treatments so that the effect of TMZ could be better scrutinized. We identified 1157 GBM patients. The median overall survival (OS), in months, was 8.3 (95% confidence interval: 7.6-9.0) and 10.1 (95% confidence interval: 9.1-11.0) in the pre-TMZ and TMZ eras, respectively (P < .001). By treatment, we found median OS for the control, RT alone, and RT + TMZ groups to be 2.5, 9.0, and 16.2 months, respectively (P < .001). Two-year survival was 0%, 4%, and 25%, respectively. The effect of age on TMZ effect was insignificant. In the matched group analysis, TMZ provided a 7.6-month OS benefit. Our population data reproduce the beneficial effect of TMZ from randomized controlled trials with a median OS of 16.2 months and 25% 2-year survival.
替莫唑胺（TMZ）联合放疗（RT）治疗多形性胶质母细胞瘤（GBM）的疗效已在随机对照试验中得到充分证实。在这里，我们根据人群水平研究了 TMZ 联合 RT 的疗效。从 2000 年 1 月 1 日至 2007 年 12 月 31 日，我们在挪威癌症登记处搜索了诊断为 GBM 的患者。随后，从挪威处方数据库中获得了这些患者的处方信息。我们根据时代（TMZ 引入前或引入后）和接受的治疗进行了数据分析。此外，我们还采用了匹配程序来减少 RT + TMZ 和 RT 单独治疗之间的偏差，以便更好地研究 TMZ 的作用。我们共确定了 1157 例 GBM 患者。TMZ 引入前和引入后的中位总生存期（OS）分别为 8.3（95%置信区间：7.6-9.0）和 10.1（95%置信区间：9.1-11.0）（P<.001）。按治疗方法，对照组、单独 RT 组和 RT + TMZ 组的中位 OS 分别为 2.5、9.0 和 16.2 个月（P<.001）。2 年生存率分别为 0%、4%和 25%。年龄对 TMZ 疗效的影响不显著。在匹配组分析中，TMZ 可使 OS 获益 7.6 个月。我们的人群数据再现了 TMZ 的有益疗效，中位 OS 为 16.2 个月，2 年生存率为 25%。
