Brain Tumor Combination Treatment Improves Survival
Temozolomide plus radiation more effective than radiation alone
MONDAY, Mar. 9 (HealthDay News) -- Combined postoperative treatment of glioblastoma patients with radiation and temozolomide improves five-year survival over radiation alone, though most patients still eventually die of the disease, according to an article published online Mar. 9 in The Lancet Oncology.
Roger Stupp, M.D., from the University of Lausanne in Switzerland, and colleagues randomly assigned 573 adults with newly diagnosed glioblastoma to radiotherapy or radiotherapy plus temozolomide followed by adjuvant temozolomide. The authors had previously reported earlier results from the trial and now report long-term follow-up after a median of more than five years.
The researchers report that, during follow-up, 97 percent of patients treated with radiotherapy alone died compared with 89 percent of patients treated with radiotherapy plus temozolomide. Overall survival was consistently higher throughout follow-up in the temozolomide group (9.8 versus 1.9 percent for radiotherapy alone at five years, hazard ratio 0.6), the investigators found. Combined therapy benefited patients in all clinical prognostic subgroups. Methylation of the O-6-methylguanine-DNA methyltransferase promoter was strongly predictive of survival only in patients receiving combination treatment. Both groups had acceptable acute toxicity and quality of life, according to the authors.
"The survival advantage of combined treatment lasts for up to five years of follow-up; nevertheless, most patients successfully treated with combined therapy eventually had tumor recurrence and died," Stupp and colleagues conclude. "Survival does not plateau, and combined treatment is unlikely to be curative for many patients."
The study was partly funded by Schering-Plough, maker of temozolomide, and several authors have received funding and fees from Schering-Plough and other pharmaceutical companies.