Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival

Abstract Objective Glioblastoma multiforme (GBM) is the most common primary malignant central nervous system (CNS) tumor. The Stupp regimen is the standard treatment, although the optimal number of temozolomide (TMZ) treatment cycles remains controversial. We compared the effects of standard 6 cycle...

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Autores principales:	Bin Huang, Zuan Yu, Risheng Liang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Glioblastoma Long-term adjuvant chemotherapy;progression-freesurvival Cancer survival Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/e5c574d1907e4af79d50d36f3d739134
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spelling	oai:doaj.org-article:e5c574d1907e4af79d50d36f3d7391342021-11-07T12:23:08ZEffect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival10.1186/s12883-021-02461-91471-2377https://doaj.org/article/e5c574d1907e4af79d50d36f3d7391342021-11-01T00:00:00Zhttps://doi.org/10.1186/s12883-021-02461-9https://doaj.org/toc/1471-2377Abstract Objective Glioblastoma multiforme (GBM) is the most common primary malignant central nervous system (CNS) tumor. The Stupp regimen is the standard treatment, although the optimal number of temozolomide (TMZ) treatment cycles remains controversial. We compared the effects of standard 6 cycles versus > 6 cycles of TMZ chemotherapy post-surgery with concurrent chemoradiotherapy on primary GBM patient survival. Patients and methods We performed a single center retrospective study of GBM patients that underwent total resection, concurrent chemoradiotherapy, and at least 6 cycles of adjuvant TMZ chemotherapy from June 2011 to August 2018. Patients were divided into 2 groups based on adjuvant TMZ treatment plan: Group A(n = 27): standard 6-cycle adjuvant TMZ therapy and Group B(n = 26): > 6 cycles of adjuvant TMZ therapy. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Continuous variables were analyzed by ANOVA, and the Kaplan-Meier method was used to evaluate PFS and OS. Univariate and multivariate COX analyses determined correlation between survival rates and covariates. We used The Mini Mental State Examination (MMSE) and Karnofsky Performance Status (KPS) to assess patients’ neurocognitive function and quality of life. Results After follow-up, median PFS was 15 months in in Group A (95%CI 9.5–20.5) and 20.1 months in Group B (95%CI 15.9–24.4). Group A median OS was 19.4 months (95%CI 15.5–23.2), compared to 25.6 months in Group B (95%CI 20.4–30.8). The 2-year survival rate of Groups A and B was 36% was 66%, respectively (P = 0.02). and 5-year survival was 7% in both. Multivariate COX regression analysis showed association between patient PFS and long-period adjuvant chemotherapy, but not OS. There were no significant difference in disability or quality of life during treatment with Stupp protocol, but differences in MMSE and KPS were in favour of the Groups B after year 1 of the treatment (P < 0.05). Conclusions Long-term adjuvant TMZ chemotherapy was beneficial for PFS and 2-year survival rate in GBM patients, and improved their quality of life contemporarily. But OS was not significantly improved.Bin HuangZuan YuRisheng LiangBMCarticleGlioblastomaLong-term adjuvant chemotherapy;progression-freesurvivalCancer survivalNeurology. Diseases of the nervous systemRC346-429ENBMC Neurology, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Glioblastoma Long-term adjuvant chemotherapy;progression-freesurvival Cancer survival Neurology. Diseases of the nervous system RC346-429
spellingShingle	Glioblastoma Long-term adjuvant chemotherapy;progression-freesurvival Cancer survival Neurology. Diseases of the nervous system RC346-429 Bin Huang Zuan Yu Risheng Liang Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival
description	Abstract Objective Glioblastoma multiforme (GBM) is the most common primary malignant central nervous system (CNS) tumor. The Stupp regimen is the standard treatment, although the optimal number of temozolomide (TMZ) treatment cycles remains controversial. We compared the effects of standard 6 cycles versus > 6 cycles of TMZ chemotherapy post-surgery with concurrent chemoradiotherapy on primary GBM patient survival. Patients and methods We performed a single center retrospective study of GBM patients that underwent total resection, concurrent chemoradiotherapy, and at least 6 cycles of adjuvant TMZ chemotherapy from June 2011 to August 2018. Patients were divided into 2 groups based on adjuvant TMZ treatment plan: Group A(n = 27): standard 6-cycle adjuvant TMZ therapy and Group B(n = 26): > 6 cycles of adjuvant TMZ therapy. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Continuous variables were analyzed by ANOVA, and the Kaplan-Meier method was used to evaluate PFS and OS. Univariate and multivariate COX analyses determined correlation between survival rates and covariates. We used The Mini Mental State Examination (MMSE) and Karnofsky Performance Status (KPS) to assess patients’ neurocognitive function and quality of life. Results After follow-up, median PFS was 15 months in in Group A (95%CI 9.5–20.5) and 20.1 months in Group B (95%CI 15.9–24.4). Group A median OS was 19.4 months (95%CI 15.5–23.2), compared to 25.6 months in Group B (95%CI 20.4–30.8). The 2-year survival rate of Groups A and B was 36% was 66%, respectively (P = 0.02). and 5-year survival was 7% in both. Multivariate COX regression analysis showed association between patient PFS and long-period adjuvant chemotherapy, but not OS. There were no significant difference in disability or quality of life during treatment with Stupp protocol, but differences in MMSE and KPS were in favour of the Groups B after year 1 of the treatment (P < 0.05). Conclusions Long-term adjuvant TMZ chemotherapy was beneficial for PFS and 2-year survival rate in GBM patients, and improved their quality of life contemporarily. But OS was not significantly improved.
format	article
author	Bin Huang Zuan Yu Risheng Liang
author_facet	Bin Huang Zuan Yu Risheng Liang
author_sort	Bin Huang
title	Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival
title_short	Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival
title_full	Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival
title_fullStr	Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival
title_full_unstemmed	Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival
title_sort	effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e5c574d1907e4af79d50d36f3d739134
work_keys_str_mv	AT binhuang effectoflongtermadjuvanttemozolomidechemotherapyonprimaryglioblastomapatientsurvival AT zuanyu effectoflongtermadjuvanttemozolomidechemotherapyonprimaryglioblastomapatientsurvival AT rishengliang effectoflongtermadjuvanttemozolomidechemotherapyonprimaryglioblastomapatientsurvival
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Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival

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