Department of Radiation Oncology, Meram Faculty of Medicine, Selcuk University, Konya, Turkey.
Radiol Oncol. 2011 Sep;45(3):213-9. doi: 10.2478/v10019-011-0019-2. Epub 2011 Jul 20.
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.
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.
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).
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.
本回顾性研究的目的是评估接受三维适形放疗（RT）联合术后同期和/或辅助替莫唑胺（TMZ）治疗的新诊断胶质母细胞瘤患者的预后和预后因素。
50 例多形性胶质母细胞瘤患者接受三维适形 RT 联合术后同期和/或辅助 TMZ 治疗。中位年龄为 57 岁（范围 12-79），Karnofsky 表现状态（KPS）中位数为 70（范围 40-100）。使用多变量 Cox 回归模型来测试年龄、性别、KPS、手术范围、肿瘤大小（<5cm 与≥5cm）、全剂量 RT（≥60Gy 与<60Gy）、同期 TMZ 和辅助 TMZ 治疗（辅助治疗加 6 个周期 TMZ 组与<6 个周期 TMZ 组）对总生存期的影响。
中位随访时间为 10 个月（范围 3-42）。1 年和 2 年总生存率分别为 46%和 20%。对总生存期有重要影响的预后因素是全剂量 RT（≥60Gy）（p=0.005）和应用 6 个周期辅助 TMZ（p=0.009）。
我们的研究结果证实了 RT 联合同期和辅助 TMZ 的有效性，且毒性可接受。我们建议至少应给予 6 个周期的辅助 TMZ，以从辅助治疗中获益。
