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KMID : 0939920170490010193
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대한암학회지
2017 Volume.49 No. 1 p.193 ~ p.203
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Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea
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Kim Byung-Sup
Seol Ho-Jun
Nam Do-Hyun
Park Chul-Kee
Kim Il-Han
Kim Tae-MIn
Kim Jeong-Hoon
Cho Young-Hyun
Yoon Sang-Min
Chang Jong-Hee
Kang Seok-Gu
Kim Eui-Hyun
Suh Chang-Ok
Jung Tae-Young
Lee Kyung-Hwa
Kim Chae-Yong
Kim In-Ah
Hong Chang-Ki
Yoo Heon
Kim Jin-Hee
Kang Shin-Hyuk
Kang Min-Kyu
Kim Eun-Young
Kim Sun-Hwan
Chung Dong-Sup
Hwang Sun-Chul
Song Joon-Ho
Cho Sung-Jin
Lee Sun-Il
Lee Youn-Soo
Ahn Kook-Jin
Kim Se-Hoon
Lim Do-Hun
Gwak Ho-Shin
Lee Se-Hoon
Hong Yong-Kil
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Abstract
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Purpose: The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample.
Materials and Methods: A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively.
Results: After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients, respectively. The methylation status of O6-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period.
Conclusion: Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.
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KEYWORD
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Glioblastoma, Temozolomide, MGMT, Chemoradiotherapy
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