From: Subject: NEJM -- Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma Date: Wed, 7 Jun 2006 10:09:37 +0200 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_00BF_01C68A1A.7B624B60" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.2869 This is a multi-part message in MIME format. ------=_NextPart_000_00BF_01C68A1A.7B624B60 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Content-Location: http://content.nejm.org/cgi/content/abstract/352/10/987?ijkey=c8276c306c66ac75c33a74ea6761089fea935b99 NEJM -- Radiotherapy plus Concomitant and Adjuvant = Temozolomide for Glioblastoma
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Radiotherapy plus Concomitant and Adjuvant Temozolomide for=20 Glioblastoma
Roger Stupp, M.D., Warren P. Mason, M.D., = Martin J. van=20 den Bent, M.D., Michael Weller, M.D., Barbara Fisher, M.D., Martin J.B.=20 Taphoorn, M.D., Karl Belanger, M.D., Alba A. Brandes, M.D., Christine = Marosi,=20 M.D., Ulrich Bogdahn, M.D., J=FCrgen Curschmann, M.D., Robert C. Janzer, = M.D.,=20 Samuel K. Ludwin, M.D., Thierry Gorlia, M.Sc., Anouk Allgeier, Ph.D., = Denis=20 Lacombe, M.D., J. Gregory Cairncross, M.D., Elizabeth Eisenhauer, M.D., = Ren=E9 O.=20 Mirimanoff, M.D., for the European Organisation for Research and = Treatment of=20 Cancer Brain Tumor and Radiotherapy Groups and the National Cancer = Institute of=20 Canada Clinical Trials Group

 
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3D""=20 by=20 DeAngelis, L.=20 = M.
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ABSTRACT

Background Glioblastoma, the = most common=20 primary brain tumor in adults, is usually rapidly fatal. The = current=20 standard of care for newly diagnosed glioblastoma is surgical = resection to the extent feasible, followed by adjuvant = radiotherapy.=20 In this trial we compared radiotherapy alone with = radiotherapy=20 plus temozolomide, given concomitantly with and after = radiotherapy,=20 in terms of efficacy and safety.

Methods Patients with newly diagnosed, histologically = confirmed=20 glioblastoma were randomly assigned to receive radiotherapy=20 alone (fractionated focal irradiation in daily fractions of = 2=20 Gy given 5 days per week for 6 weeks, for a total of 60 Gy) = or=20 radiotherapy plus continuous daily temozolomide (75 mg per = square=20 meter of body-surface area per day, 7 days per week from the = first to=20 the last day of radiotherapy), followed by six cycles of = adjuvant=20 temozolomide (150 to 200 mg per square meter for 5 days = during each=20 28-day cycle). The primary end point was overall = survival.=20

Results A total of 573 patients from 85 centers underwent=20 randomization. The median age was 56 years, and 84 percent of = patients had undergone debulking surgery. At a median = follow-up of 28=20 months, the median survival was 14.6 months with radiotherapy = plus=20 temozolomide and 12.1 months with radiotherapy alone. The = unadjusted=20 hazard ratio for death in the radiotherapy-plus-temozolomide=20 group was 0.63 (95 percent confidence interval, 0.52 to 0.75; = P<0.001 by the log-rank test). The two-year survival rate = was 26.5=20 percent with radiotherapy plus temozolomide and 10.4 percent = with=20 radiotherapy alone. Concomitant treatment with radiotherapy = plus=20 temozolomide resulted in grade 3 or 4 hematologic toxic = effects in 7=20 percent of patients.

Conclusions The addition of temozolomide to radiotherapy = for=20 newly diagnosed glioblastoma resulted in a clinically = meaningful=20 and statistically significant survival benefit with minimal=20 additional toxicity.


Source=20 Information

From the Centre Hospitalier Universitaire Vaudois, = Lausanne,=20 Switzerland (R.S., R-C.J., R.O.M.); Princess Margaret Hospital, Toronto=20 (W.P.M.); Daniel den Hoed Oncology Center=96Erasmus University Medical = Center=20 Rotterdam, Rotterdam, the Netherlands (M.J.B.); the University of = T=FCbingen=20 Medical School, T=FCbingen, Germany (M.W.); the University of Western = Ontario,=20 London, Ont., Canada (B.F.); the University Medical Center, Utrecht, the = Netherlands (M.J.B.T.); H=F4pital Notre Dame du Centre Hospitalier = Universitaire,=20 Montreal (K.B.); Azienda-Ospedale Universit=E0, Padova, Italy (A.A.B.); = Medical=20 University of Vienna, Vienna (C.M.); Universit=E4tskliniken, Regensburg, = Germany=20 (U.B.); Inselspital, Bern, Switzerland (J.C.); Queen's University, = Kingston,=20 Ont., Canada (S.K.L.); the European Organisation for Research and = Treatment of=20 Cancer Data Center, Brussels (T.G., A.A., D.L.); the University of = Calgary,=20 Calgary, Alta., Canada (J.G.C.); and the National Cancer Institute of = Canada=20 Clinical Trials Group, Kingston, Ont., Canada (E.E.).

Address reprint requests to Dr. Stupp at the = Multidisciplinary=20 Oncology Center, Centre Hospitalier Universitaire Vaudois, 46, rue du = Bugnon,=20 CH-1011 Lausanne, Switzerland, or at roger.stupp{at}chuv.hospvd.ch .

Full Text = of this=20 Article


Related Letters:=20

Treatment = of Brain=20 Tumors
Paulino A. C., Teh B. S., Sadeh M., Seiter K., = Ashby L.,=20 LaRocca R., Ryken T., Aiken R. D., Rutkowski S., Ottensmeier H., Pietsch = T.,=20 Stupp R., Hegi M. E., DeAngelis L. M.
Extract<= /A> | Full = Text | PDF =  
N=20 Engl J Med 2005; 352:2350-2353, Jun 2, 2005. Correspondence =

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