Jaoude Dory Abou, Moore Joseph A, Moore Matthew B, Twumasi-Ankrah Philip, Ablah Elizabeth, Moore Dennis F
Ascension Via Christi, Wichita, KS.
University of Texas Southwestern Medical Center, Dallas, TX.
Kans J Med. 2019 Aug 21;12(3):65-69. eCollection 2019 Aug.
The five-year survival rate for patients with glioblastoma (GBM) is low at approximately 4.7%. Radiotherapy plus concomitant and adjuvant temozolomide (TMZ) remains the standard of care. The optimal duration of therapy with TMZ is unknown. This study sought to evaluate the survival benefit of two years of treatment.
This was a retrospective chart review of all patients diagnosed with GBM and treated with TMZ for up to two years between January 1, 2002 and December 31, 2011. The Kaplan-Meier method with log-rank test was used to estimate the progression-free survival (PFS) and the overall survival (OS). The results were compared to historical controls and data from previous clinical trials of patients treated up to one year.
Data from 56 patients with confirmed GBM were evaluated. The OS probability was 54% (SE = 0.068) at one year, 28.3% (SE = 0.064) at two years, 17.8% (SE = 0.059) at three years, and 4% (SE = 0.041) at five years. Seven patients (12.5%) were treated with TMZ for two years. Their median time-to-progression was 28 months (95% CI = 5.0 - 28.0), and they had an increased survival probability at three years compared to other patients (log-rank test χ (1, N = 56) = 19.2, p < 0.0001).
There may be an advantage for a longer duration of TMZ therapy among patients with GBM, but the sample size was too small for generalization. A multicenter prospective study is needed to identify optimal duration of TMZ therapy.
胶质母细胞瘤（GBM）患者的五年生存率较低，约为4.7%。放疗联合同步及辅助替莫唑胺（TMZ）仍然是标准治疗方案。TMZ的最佳治疗时长尚不清楚。本研究旨在评估两年治疗的生存获益。
这是一项对2002年1月1日至2011年12月31日期间所有诊断为GBM并接受TMZ治疗长达两年的患者进行的回顾性病历审查。采用带有对数秩检验的Kaplan-Meier方法来估计无进展生存期（PFS）和总生存期（OS）。将结果与历史对照以及既往治疗时长达一年的患者的临床试验数据进行比较。
对56例确诊为GBM的患者数据进行了评估。一年时的OS概率为54%（标准误=0.068），两年时为28.3%（标准误=0.064），三年时为17.8%（标准误=0.059），五年时为4%（标准误=0.041）。7例患者（12.5%）接受了两年的TMZ治疗。他们的中位疾病进展时间为28个月（95%置信区间=5.0 - 28.0），与其他患者相比，他们三年时的生存概率有所增加（对数秩检验χ(1, N = 56)=19.2，p<0.0001）。
GBM患者中TMZ治疗时长延长可能存在优势，但样本量过小无法进行推广。需要开展多中心前瞻性研究来确定TMZ治疗的最佳时长。
