Extended cycles of adjuvant temozolomide improves survival outcomes in glioblastoma:a retrospective analysis  

作　　者：Hao Xu Shengnan Yu Chunyan Wang Yue Hu Qinglan Ren Lihao Jiang 

机构地区：[1]Department of Oncology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China [2]Department of Oncology,The Peoples Hospital of DAZU District,Chongqing 402360,China

出　　处：《Journal of Cancer Metastasis and Treatment》2024年第1期348-361,共14页癌症转移与治疗(英文版)

基　　金：supported by the National Natural Science Foundation of China(No.82203007).

摘　　要：Aim:Standard treatment includes post-surgical chemoradiotherapy and adjuvant temozolomide(TMz)for glioblastoma(GBM).There is no consensus on the optimal duration for adjuvant TMZ.This study assessed whether prolonging adjuvant TMZ improved survival outcomes.Methods:We retrospectively analyzed data of GBM patients who met inclusion criteria at our institute from September 2013 to December 2022.Patients who received 6 cycles of maintenance TMZ constituted the standard group,whereas those who underwent>6 cycles were classified into the extended group.Kaplan-Meier method Was used to estimate the median progression-free survival(PFS)and overall survival(OS).Independent predictors of OS and PFS were explored by Cox regression analyses.Results:100 patients were enrolled.Extended adjuvant TMZ significantly improved OS(28.0 vs.10.0 months,P<0.001)and PFS(22.0 vs.8.0 months,P<0.001)in newly diagnosed GBM patients.Subgroup analysis showed that patients with MGMT promoter methylation who received>6 cycles of adjuvant TMZ experienced a significant increase in 0S(34.0 vs.9.0 months,P<0.001)and PFS(26.0 vs.9.0 months,P=0.008).Additionally,in the extended group,patients with MGMT promoter methylation had better survival outcomes compared to MGMT promoter unmethylated patients(OS:34.0 vs.17.0 months,P=0.013;PFS:26.0 vs.12.0 months,P=0.025).In patients with solitary GBM,extended adjuvant TMZ resulted in better OS(11.0 vs.32months,P=0.007)and PFS(9.0 vs.24.0 months,P<0.001).For patients with multiple GBM,undergoing six or more cycles of adjuvant TMZ did not significantly impact OS(P=0.100)and PFS(P=0.067).The Karnofsky Performance Status(KPS)is employed to assess the health condition of surgical patients.Patients with KPS>70 exhibited better survival outcomes in the extended group.Nausea and vomiting were the main adverse events reported in both cohorts.However,fatigue emerged as the most severe side effect,specifically within the extended group.Conclusion:This study indicated that prolonged adjuvant TMZ significantly enhanced OS a

关 键 词：GLIOBLASTOMA adjuvant temozolomide MGMT promoter methylation overall survival 

分 类 号：R73[医药卫生—肿瘤]