Originally published as JCO Early Release 10.1200/JCO.2008.19.4969 on February 2 2009

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Brandes, A. A. Articles by Ermani, M. Search for Related Content PubMed PubMed Citation Articles by Brandes, A. A. Articles by Ermani, M. Social Bookmarking                            What's this?

Recurrence Pattern After Temozolomide Concomitant With and Adjuvant to Radiotherapy in Newly Diagnosed Patients With Glioblastoma: Correlation With MGMT Promoter Methylation Status

From the Medical Oncology and Radiotherapy Departments, Bellaria-Maggiore Hospital, Azienda Unità Sanitaria Locale of Bologna; Pathology Department, Bellaria Hospital, University of Bologna, Bologna; Radiotherapy Department, Istituto Oncologico Veneto; Neurosciences Department, Statistic and Informatic Unit, Azienda Ospedale-Università, Padova; and Neuroradiology Department, Santa Maria della Misericordia Hospital, Rovigo, Italy.

Corresponding author: Alba A. Brandes, MD, Department of Medical Oncology, Azienda USL Bellaria-Maggiore Hospital, Bologna, Italy; e-mail: alba.brandes{at}yahoo.it.

Purpose The aim of the present study was to evaluate factors predicting the recurrence pattern after the administration of temozolomide (TMZ), initially concurrent with radiotherapy (RT) and subsequently as maintenance therapy, which has become standard treatment for patients with newly diagnosed glioblastoma (GBM).

Patients and Methods Ninety-five patients with newly diagnosed GBM were treated with RT plus TMZ (75 mg/m²/d) followed by maintenance TMZ cycles (150 to 200 mg/m² for 5 days every 28 days). Assessable MGMT methylation status and magnetic resonance imaging follow-up were mandatory in all cases.

Results After a median follow-up of 18.9 months (range, 6.6 to 44.8 months), 79 patients (83%) had recurrence: inside the RT field in 57 patients (72.2%), outside in 17 patients (21.5%), and at RT margin in five patients (6.3%). MGMT status was correlated with the site of recurrence, which occurred inside, or at the margin of, the RT field in 51 patients (85%) with MGMT unmethylated status and in 11 patients (57.9%) with MGMT methylated status (P = .01). Recurrences outside the RT field occurred after a longer time interval than those inside the RT field (14.9 v 9.2 months, P = .02).

Conclusion After the administration of TMZ concomitant with and adjuvant to RT in patients with GBM, the pattern of, and time to, recurrence are strictly correlated with MGMT methylation status.

Supported by the Research and Development Unit of Azienda Ospedale-Università, Padova, Italy.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				S. SHARMA, F. SALEHI, B. W. SCHEITHAUER, F. ROTONDO, L. V. SYRO, and K. KOVACS Role of MGMT in Tumor Development, Progression, Diagnosis, Treatment and Prognosis Anticancer Res, October 1, 2009; 29(10): 3759 - 3768. [Abstract] [Full Text] [PDF]