Feasibility and safety of extended adjuvant temozolomide beyond six cycles for patients with glioblastoma
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Temozolomide is the first chemotherapeutic agent proven effective for patients with newly diagnosed glioblastoma. The drug is well tolerated for its low toxicity. The current standard practice is concomitant chemoradiotherapy for 6 weeks followed by 6 cycles of adjuvant temozolomide. Some Caucasian studies have suggested that patients might benefit from extended adjuvant cycles of temozolomide (>6 cycles) to lengthen both progression-free survival and overall survival. In the present study, we compared differences in survival and toxicity profile between patients who received conventional 6-cycle temozolomide and those who received more than 6 cycles of temozolomide.

Patients with newly diagnosed glioblastoma without progressive disease and completed concomitant chemoradiotherapy during a 4-year period were studied. Progression-free survival was compared using Kaplan-Meier survival curves. T-test, U-test, and correlation were chosen accordingly to examine the impact of age, extent of resection, MGMT promoter methylation status and adjuvant cycles on progression-free survival. For factors with a P value of <0.05 in univariate analyses, Cox regression hazard model was adopted to determine the strongest factors related to progression-free survival.

The median progression-free survival was 17.0 months for patients who received 6 cycles of temozolomide (n=7) and 43.4 months for those who received more than 6 cycles (n=7) [P=0.007, log-rank test]. Two patients in the former group and one in the latter group encountered grade 1 toxicity and recovered following dose adjustment. Cycles of adjuvant temozolomide were correlated with progression-free survival (P=0.016, hazard ratio=0.68).

Extended cycles of temozolomide are safe and feasible for Chinese patients with disease responsive to temozolomide.
Acceptance Date02/12/2016
All Author(s) ListSonia YP Hsieh, Danny TM Chan, Michael KM Kam, Herbert HF Loong, WK Tsang, Darren MC Poon, Stephanie CP Ng, WS Poon
Journal nameHong Kong Medical Journal
Volume Number23
Issue Number6
PublisherHong Kong Academy of Medicine
Place of PublicationHong Kong
Pages594 - 598
LanguagesEnglish-United Kingdom
KeywordsAntineoplastic agents, alkylating, Disease-free survival, Glioblastoma

Last updated on 2020-14-09 at 01:38