Concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide for newly diagnosed glioblastoma patients: A retrospective multicenter observation study in Korea

Byung Sup Kim, Do Hyun Nam, Il Han Kim, Jeong Hoon Kim, Sang Min Yoon, Seok Gu Kang, Chang Ok Suh, Kyung Hwa Lee, In Ah Kim, Heon Yoo, Shin-Hyuk Kang, Eun Young Kim, Dong Sup Chung, Joon Ho Song, Sun Il Lee, Kook Jin Ahn, Do Hun Lim, Se Hoon Lee, Ho Jun Seol, Chul Kee ParkTae Min Kim, Young Hyun Cho, Jong Hee Chang, Eui Hyun Kim, Tae Young Jung, Chae Yong Kim, Chang Ki Hong, Jin Hee Kim, Min Kyu Kang, Sun Hwan Kim, Sun Chul Hwang, Sung Jin Cho, Youn Soo Lee, Se Hoon Kim, Ho Shin Gwak, Yong Kil Hong

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Abstract

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.

Original languageEnglish
Pages (from-to)193-203
Number of pages11
JournalCancer Research and Treatment
Volume49
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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temozolomide
Chemoradiotherapy
Glioblastoma
Korea
Multicenter Studies
Observation
Disease-Free Survival
Methyltransferases
Survival
DNA
Methylation
Survival Rate
Biopsy
Adjuvant Radiotherapy

Keywords

  • Chemoradiotherapy
  • Glioblastoma
  • MGMT
  • Temozolomide

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide for newly diagnosed glioblastoma patients : A retrospective multicenter observation study in Korea. / Kim, Byung Sup; Nam, Do Hyun; Kim, Il Han; Kim, Jeong Hoon; Yoon, Sang Min; Kang, Seok Gu; Suh, Chang Ok; Lee, Kyung Hwa; Kim, In Ah; Yoo, Heon; Kang, Shin-Hyuk; Kim, Eun Young; Chung, Dong Sup; Song, Joon Ho; Lee, Sun Il; Ahn, Kook Jin; Lim, Do Hun; Lee, Se Hoon; Seol, Ho Jun; Park, Chul Kee; Kim, Tae Min; Cho, Young Hyun; Chang, Jong Hee; Kim, Eui Hyun; Jung, Tae Young; Kim, Chae Yong; Hong, Chang Ki; Kim, Jin Hee; Kang, Min Kyu; Kim, Sun Hwan; Hwang, Sun Chul; Cho, Sung Jin; Lee, Youn Soo; Kim, Se Hoon; Gwak, Ho Shin; Hong, Yong Kil.

In: Cancer Research and Treatment, Vol. 49, No. 1, 01.01.2017, p. 193-203.

Research output: Contribution to journalArticle

Kim, BS, Nam, DH, Kim, IH, Kim, JH, Yoon, SM, Kang, SG, Suh, CO, Lee, KH, Kim, IA, Yoo, H, Kang, S-H, Kim, EY, Chung, DS, Song, JH, Lee, SI, Ahn, KJ, Lim, DH, Lee, SH, Seol, HJ, Park, CK, Kim, TM, Cho, YH, Chang, JH, Kim, EH, Jung, TY, Kim, CY, Hong, CK, Kim, JH, Kang, MK, Kim, SH, Hwang, SC, Cho, SJ, Lee, YS, Kim, SH, Gwak, HS & Hong, YK 2017, 'Concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide for newly diagnosed glioblastoma patients: A retrospective multicenter observation study in Korea', Cancer Research and Treatment, vol. 49, no. 1, pp. 193-203. https://doi.org/10.4143/crt.2015.473
Kim, Byung Sup ; Nam, Do Hyun ; Kim, Il Han ; Kim, Jeong Hoon ; Yoon, Sang Min ; Kang, Seok Gu ; Suh, Chang Ok ; Lee, Kyung Hwa ; Kim, In Ah ; Yoo, Heon ; Kang, Shin-Hyuk ; Kim, Eun Young ; Chung, Dong Sup ; Song, Joon Ho ; Lee, Sun Il ; Ahn, Kook Jin ; Lim, Do Hun ; Lee, Se Hoon ; Seol, Ho Jun ; Park, Chul Kee ; Kim, Tae Min ; Cho, Young Hyun ; Chang, Jong Hee ; Kim, Eui Hyun ; Jung, Tae Young ; Kim, Chae Yong ; Hong, Chang Ki ; Kim, Jin Hee ; Kang, Min Kyu ; Kim, Sun Hwan ; Hwang, Sun Chul ; Cho, Sung Jin ; Lee, Youn Soo ; Kim, Se Hoon ; Gwak, Ho Shin ; Hong, Yong Kil. / Concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide for newly diagnosed glioblastoma patients : A retrospective multicenter observation study in Korea. In: Cancer Research and Treatment. 2017 ; Vol. 49, No. 1. pp. 193-203.
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title = "Concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide for newly diagnosed glioblastoma patients: A retrospective multicenter observation study in Korea",
abstract = "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.",
keywords = "Chemoradiotherapy, Glioblastoma, MGMT, Temozolomide",
author = "Kim, {Byung Sup} and Nam, {Do Hyun} and Kim, {Il Han} and Kim, {Jeong Hoon} and Yoon, {Sang Min} and Kang, {Seok Gu} and Suh, {Chang Ok} and Lee, {Kyung Hwa} and Kim, {In Ah} and Heon Yoo and Shin-Hyuk Kang and Kim, {Eun Young} and Chung, {Dong Sup} and Song, {Joon Ho} and Lee, {Sun Il} and Ahn, {Kook Jin} and Lim, {Do Hun} and Lee, {Se Hoon} and Seol, {Ho Jun} and Park, {Chul Kee} and Kim, {Tae Min} and Cho, {Young Hyun} and Chang, {Jong Hee} and Kim, {Eui Hyun} and Jung, {Tae Young} and Kim, {Chae Yong} and Hong, {Chang Ki} and Kim, {Jin Hee} and Kang, {Min Kyu} and Kim, {Sun Hwan} and Hwang, {Sun Chul} and Cho, {Sung Jin} and Lee, {Youn Soo} and Kim, {Se Hoon} and Gwak, {Ho Shin} and Hong, {Yong Kil}",
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TY - JOUR

T1 - Concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide for newly diagnosed glioblastoma patients

T2 - A retrospective multicenter observation study in Korea

AU - Kim, Byung Sup

AU - Nam, Do Hyun

AU - Kim, Il Han

AU - Kim, Jeong Hoon

AU - Yoon, Sang Min

AU - Kang, Seok Gu

AU - Suh, Chang Ok

AU - Lee, Kyung Hwa

AU - Kim, In Ah

AU - Yoo, Heon

AU - Kang, Shin-Hyuk

AU - Kim, Eun Young

AU - Chung, Dong Sup

AU - Song, Joon Ho

AU - Lee, Sun Il

AU - Ahn, Kook Jin

AU - Lim, Do Hun

AU - Lee, Se Hoon

AU - Seol, Ho Jun

AU - Park, Chul Kee

AU - Kim, Tae Min

AU - Cho, Young Hyun

AU - Chang, Jong Hee

AU - Kim, Eui Hyun

AU - Jung, Tae Young

AU - Kim, Chae Yong

AU - Hong, Chang Ki

AU - Kim, Jin Hee

AU - Kang, Min Kyu

AU - Kim, Sun Hwan

AU - Hwang, Sun Chul

AU - Cho, Sung Jin

AU - Lee, Youn Soo

AU - Kim, Se Hoon

AU - Gwak, Ho Shin

AU - Hong, Yong Kil

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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.

AB - 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.

KW - Chemoradiotherapy

KW - Glioblastoma

KW - MGMT

KW - Temozolomide

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