| Chemoradiotherapy of newly diagnosed glioblastoma with intensified temozolomide. | |
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MedLine Citation:
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PMID: 19836157 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To evaluate the toxicity and efficacy of chemoradiotherapy with temozolomide (TMZ) administered in an intensified 1-week on/1-week off schedule plus indomethacin in patients with newly diagnosed glioblastoma. PATIENTS AND METHODS: A total of 41 adult patients (median Karnofsky performance status, 90%; median age, 56 years) were treated with preirradiation TMZ at 150 mg/m(2) (1 week on/1 week off), involved-field radiotherapy combined with concomitant low-dose TMZ (50 mg/m(2)), maintenance TMZ starting at 150 mg/m(2) using a 1-week on/1-week off schedule, plus maintenance indomethacin (25 mg twice daily). RESULTS: The median follow-up interval was 21.7 months. Grade 4 hematologic toxicity was observed in 15 patients (36.6%). Treatment-related nonhematologic Grade 4-5 toxicity was reported for 2 patients (4.9%). The median progression-free survival was 7.6 months (95% confidence interval, 6.2-10.4). The 1-year survival rate was 73.2% (95% confidence interval, 56.8-84.2%). The presence of O(6)-methylguanine-DNA methyltransferase (MGMT) gene promoter methylation in the tumor tissue was associated with significantly superior progression-free survival. CONCLUSION: The dose-dense regimen of TMZ administered in a 1-week on/1-week off schedule resulted in acceptable nonhematologic toxicity. Compared with data from the European Organization for Research and Treatment of Cancer/National Cancer Institute of Canada trial 26981-22981/CE.3, patients with an unmethylated MGMT gene promoter appeared not to benefit from intensifying the TMZ schedule regarding the median progression-free survival and overall survival. In contrast, data are promising for patients with a methylated MGMT promoter. |
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Authors:
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Markus Weiler; Christian Hartmann; Dorothee Wiewrodt; Ulrich Herrlinger; Thierry Gorlia; Oliver B?hr; Richard Meyermann; Michael Bamberg; Marcos Tatagiba; Andreas von Deimling; Michael Weller; Wolfgang Wick |
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Publication Detail:
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Type: Clinical Trial, Phase II; Journal Article; Multicenter Study Date: 2009-10-14 |
Journal Detail:
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Title: International journal of radiation oncology, biology, physics Volume: 77 ISSN: 1879-355X ISO Abbreviation: Int. J. Radiat. Oncol. Biol. Phys. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-05-31 Completed Date: 2010-06-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7603616 Medline TA: Int J Radiat Oncol Biol Phys Country: United States |
Other Details:
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Languages: eng Pagination: 670-6 Citation Subset: IM |
Copyright Information:
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(c) 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of General Neurology, Hertie Institute for Clinical Brain Research, University of T?bingen, T?bingen, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anti-Inflammatory Agents, Non-Steroidal / administration & dosage Antineoplastic Agents, Alkylating / administration & dosage*, adverse effects Brain Neoplasms / drug therapy*, enzymology, mortality, radiotherapy* Combined Modality Therapy / methods Confidence Intervals DNA Methylation DNA Modification Methylases / genetics DNA Repair Enzymes / genetics Dacarbazine / administration & dosage, adverse effects, analogs & derivatives* Disease-Free Survival Drug Administration Schedule Female Follow-Up Studies Germany Glioblastoma / drug therapy*, enzymology, mortality, radiotherapy* Humans Indomethacin / administration & dosage Karnofsky Performance Status Male Middle Aged Prospective Studies Survival Rate Tumor Suppressor Proteins / genetics |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 0/Antineoplastic Agents, Alkylating; 0/Tumor Suppressor Proteins; 4342-03-4/Dacarbazine; 53-86-1/Indomethacin; 85622-93-1/temozolomide; EC 2.1.1.-/DNA Modification Methylases; EC 2.1.1.63/MGMT protein, human; EC 6.5.1.-/DNA Repair Enzymes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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