Efficacy of concomitant and adjuvant temozolomide in glioblastoma treatment. A multicentre randomized study

Szczepanek, Dariusz; Marchel, Andrzej; Moskała, Marek; Krupa, Mariusz; Kunert, Przemysław; Trojanowski, Tomasz

doi:10.5114/ninp.2013.34398

Cited by 17 publications

(23 citation statements)

References 19 publications

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“…Stupp et al [14] demonstrated that a combination of TMZ with postoperative radiation prolonged the overall survival compared to radiation alone. This was supported by subsequent reports, where TMZ before, during and after RT provided clinically and statistically significant improvements in patients with newly diagnosed GBM [15,16,17]. Comparison of studies before (2000-2003) and after (2005-2008) the introduction of TMZ revealed that patients treated with surgery and radiation had a median survival of 12 months, while those treated with TMZ had a median survival of 14.2 months [6].…”

Section: Introductionsupporting

confidence: 64%

“…Of the remaining 42 articles, 30 were non-randomized studies, 1 was duplicate study, 3 did not report an outcome of interest, 1 did not analyze concomitant TMZ + RT and the full text was not available for 1 article. Thus, 6 eligible studies (5 trials) [13,14,15,17,23,24] were included in this meta-analysis. The ﬂow chart describing the selection of trials is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Except for Kocher et al [25], all included studies reported improved survival for patients in the RT + TMZ arm [14,15,16,26]. A follow-up study of the EORTC 26981 trial demonstrated benefits of adjuvant TMZ with RT that lasted for 5 years [18].…”

Section: Discussionmentioning

confidence: 99%

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Temozolomide with or without Radiotherapy in Patients with Newly Diagnosed Glioblastoma Multiforme: A Meta-Analysis

2017

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Background/Aim: The current meta-analysis evaluated the survival outcomes of newly diagnosed glioblastoma patients treated with radiotherapy (RT) alone and with RT + temozolomide (TMZ). Methods: Relevant studies were identified by an extensive literature search in Medline, Current Contents and Cochrane databases by 2 independent reviewers using the terms “glioblastoma multiforme/glioblastoma, TMZ, radiation therapy/RT and survival.” Results: Results revealed a median survival of 13.41-19 months in the combined treatment group, as opposed to 7.7-17.1 months in the RT-alone group. Progression-free survival (PFS) was also significantly different between the 2 groups (RT + TMZ, 6.3-13 months; RT-alone, 5-7.6 months). While there was no significant difference in the 6-month survival and 6-month PFS rates between the RT + TMZ and RT groups (pooled OR 0.690; p = 0.057 and OR 0.429, p = 0.052, respectively), the 1-year survival and 1-year PFS rates showed significant difference (OR 0.469; p = 0.030 and OR 0.245, p < 0.001, respectively). Conclusions: Concomitant RT + TMZ is more effective and improves the overall survival and PFS in patients with newly diagnosed glioblastoma.

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Section: Introductionsupporting

confidence: 64%

Section: Resultsmentioning

confidence: 99%

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Temozolomide with or without Radiotherapy in Patients with Newly Diagnosed Glioblastoma Multiforme: A Meta-Analysis

2017

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“…Currently, the treatment options for recurrent cases include systemic, re-irradiation, and second surgery in order to improve outcomes. The risks and benefits of radiation, chemotherapy, and surgical extent in GBM patients have been assessed in numerous studies (6)(7)(8)(9). However, the value of surgical extent in elderly patients with high-grade glioma remains unestablished.…”

Section: Introductionmentioning

confidence: 99%

Gross Total vs. Subtotal Resection on Survival Outcomes in Elderly Patients With High-Grade Glioma: A Systematic Review and Meta-Analysis

et al. 2020

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Background: The optimal strategy for the management of high-grade glioma in the elderly (≥60.0 years) remains controversial, especially regarding the effects of surgical extent on survival outcomes. The purpose of this study was to compare gross total resection (GTR) with subtotal resection (STR) for treatment effects in elderly patients with high-grade glioma.Methods: Three electronic databases were systematically searched, including PubMed, EmBase, and the Cochrane library, from inception to August 2018. Hazard ratios (HRs) or odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to express summary effect estimates using the random-effects model. Nineteen retrospective observational studies involving a total of 10,815 elderly patients with high-grade glioma were included in this meta-analysis.Results: The summary results indicated that GTR was associated with a significant improvement in overall survival (OS) compared with STR (HR = 0.70, 95% CI = 0.64-0.77). In addition, elderly patients administered GTR showed lower risk of 3-month mortality (OR = 0.47, 95% CI = 0.24-0.93), 6-month mortality (OR = 0.38, 95% CI = 0.26-0.56), 9-month mortality (OR = 0.35, 95% CI = 0.25-0.49), and 1-year mortality (OR = 0.40, 95% CI = 0.29-0.56). Pooled OS data differed when stratified by publication year, country, sample size, disease status, and study quality.Conclusion: GTR seems to be more effective than STR in achieving longer survival in elderly patients with high-grade glioma.

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“…Chemotherapy is also with limited effects, since most chemicals have difficulty in crossing the blood brain barrier [4]. Temozolomide is the most effective chemotherapeutic reagent but can usually prolong the lifespan for only 3–6 months in some patients [5, 6], with side effects. Novel therapy approaches include combinations of molecular targeted agents such as epidermal growth factor receptor, vascular endothelial growth factor receptor, and mammalian target of rapamycin.…”

Section: Introductionmentioning

confidence: 99%

Conditioned Media from Human Adipose Tissue-Derived Mesenchymal Stem Cells and Umbilical Cord-Derived Mesenchymal Stem Cells Efficiently Induced the Apoptosis and Differentiation in Human Glioma Cell Lines In Vitro

Yang

Lei

Ouyang

et al. 2014

BioMed Research International

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Human mesenchymal stem cells (MSCs) have an intrinsic property for homing towards tumor sites and can be used as tumor-tropic vectors for tumor therapy. But very limited studies investigated the antitumor properties of MSCs themselves. In this study we investigated the antiglioma properties of two easily accessible MSCs, namely, human adipose tissue-derived mesenchymal stem cells (ASCs) and umbilical cord-derived mesenchymal stem cells (UC-MSCs). We found (1) MSC conditioned media can significantly inhibit the growth of human U251 glioma cell line; (2) MSC conditioned media can significantly induce apoptosis in human U251 cell line; (3) real-time PCR experiments showed significant upregulation of apoptotic genes of both caspase-3 and caspase-9 and significant downregulation of antiapoptotic genes such as survivin and XIAP after MSC conditioned media induction in U 251 cells; (4) furthermore, MSCs conditioned media culture induced rapid and complete differentiation in U251 cells. These results indicate MSCs can efficiently induce both apoptosis and differentiation in U251 human glioma cell line. Whereas UC-MSCs are more efficient for apoptosis induction than ASCs, their capability of differentiation induction is not distinguishable from each other. Our findings suggest MSCs themselves have favorable antitumor characteristics and should be further explored in future glioma therapy.

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Efficacy of concomitant and adjuvant temozolomide in glioblastoma treatment. A multicentre randomized study

Abstract: The introduction of TMZ before, during and after radiotherapy for newly diagnosed glioblastoma multiforme gives clinically and statistically significant improvement of survival with unremarkably increased toxicity of the treatment.

Cited by 17 publications

References 19 publications

Temozolomide with or without Radiotherapy in Patients with Newly Diagnosed Glioblastoma Multiforme: A Meta-Analysis

Temozolomide with or without Radiotherapy in Patients with Newly Diagnosed Glioblastoma Multiforme: A Meta-Analysis

Gross Total vs. Subtotal Resection on Survival Outcomes in Elderly Patients With High-Grade Glioma: A Systematic Review and Meta-Analysis

Conditioned Media from Human Adipose Tissue-Derived Mesenchymal Stem Cells and Umbilical Cord-Derived Mesenchymal Stem Cells Efficiently Induced the Apoptosis and Differentiation in Human Glioma Cell Lines In Vitro

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