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Outcomes of pediatric glioblastoma treated with adjuvant chemoradiation with temozolomide and correlation with prognostic factors.

Mallick S, Gandhi AK, Joshi NP, Kumar A, Puri T, Sharma DN, Haresh KP, Gupta S, Julka PK, Rath GK, Sarkar C - Indian J Med Paediatr Oncol (2015 Apr-Jun)

Bottom Line: Other prognostic factors did not correlate with survival.Our study shows the benefit of TMZ for pGBM patients.Both concurrent and adjuvant TMZ seem to be important for superior OS in this group of patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Background: Pediatric glioblastoma (pGBM) patients are underrepresented in major trials for this disease. We aimed to explore the outcome of pGBM patients treated with concurrent and adjuvant temozolomide (TMZ).

Materials and methods: 23 patients of pGBM treated from 2004 to 2010 were included in this retrospective analysis. Adjuvant therapy included conformal radiation 60 gray at 2 gray/fraction daily over 6 weeks with concurrent TMZ 75 mg/m(2) followed by six cycles of adjuvant TMZ 150-200 mg/m(2) (day 1-5) every 4 weeks. Kaplan-Meier estimates of overall survival (OS) were determined. Univariate analysis with log-rank test was used to determine the impact of prognostic variables on survival.

Results: Median age at presentation was 11.5 years (range: 7-19 years) and M:F ratio was 15:8. All patients underwent maximal safe surgical resection; 13 gross total resection and 10 sub-total resection. At a median follow-up of 18 months (range: 2.1-126 months), the estimated median OS was 41.9 months. The estimated median OS for patients receiving only concurrent TMZ was 8 months while that for patients receiving concurrent and adjuvant TMZ was 41.9 months (P = 0.081). Estimated median OS for patients who did not complete six cycles of adjuvant TMZ was 9.5 months versus not reached for those who completed at least six cycles (P = 0.0005). Other prognostic factors did not correlate with survival.

Conclusions: Our study shows the benefit of TMZ for pGBM patients. Both concurrent and adjuvant TMZ seem to be important for superior OS in this group of patients.

No MeSH data available.


Related in: MedlinePlus

Overall survival of the entire cohort of patients
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Figure 1: Overall survival of the entire cohort of patients

Mentions: Median follow-up duration for the entire cohort was 18 months (range: 2.1-126 months). At the time of last follow-up, 7 patients had expired and 11 were asymptomatic and free of disease. Estimated median OS of the entire cohort was 41.9 months. The 1-year and 2-year estimated OS was 69.6% and 60.9%, respectively [Figure 1]. Eight patients survived more than 41 months. Of these, one patient is surviving 126 months from the time of diagnosis. Three of the 4 patients with methylated MGMT and only 1 of 4 patients with unmethylated MGMT were alive at the time of last follow-up. MGMT methylation status was not known in the patient with the longest survival of 126 months.


Outcomes of pediatric glioblastoma treated with adjuvant chemoradiation with temozolomide and correlation with prognostic factors.

Mallick S, Gandhi AK, Joshi NP, Kumar A, Puri T, Sharma DN, Haresh KP, Gupta S, Julka PK, Rath GK, Sarkar C - Indian J Med Paediatr Oncol (2015 Apr-Jun)

Overall survival of the entire cohort of patients
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4477385&req=5

Figure 1: Overall survival of the entire cohort of patients
Mentions: Median follow-up duration for the entire cohort was 18 months (range: 2.1-126 months). At the time of last follow-up, 7 patients had expired and 11 were asymptomatic and free of disease. Estimated median OS of the entire cohort was 41.9 months. The 1-year and 2-year estimated OS was 69.6% and 60.9%, respectively [Figure 1]. Eight patients survived more than 41 months. Of these, one patient is surviving 126 months from the time of diagnosis. Three of the 4 patients with methylated MGMT and only 1 of 4 patients with unmethylated MGMT were alive at the time of last follow-up. MGMT methylation status was not known in the patient with the longest survival of 126 months.

Bottom Line: Other prognostic factors did not correlate with survival.Our study shows the benefit of TMZ for pGBM patients.Both concurrent and adjuvant TMZ seem to be important for superior OS in this group of patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Background: Pediatric glioblastoma (pGBM) patients are underrepresented in major trials for this disease. We aimed to explore the outcome of pGBM patients treated with concurrent and adjuvant temozolomide (TMZ).

Materials and methods: 23 patients of pGBM treated from 2004 to 2010 were included in this retrospective analysis. Adjuvant therapy included conformal radiation 60 gray at 2 gray/fraction daily over 6 weeks with concurrent TMZ 75 mg/m(2) followed by six cycles of adjuvant TMZ 150-200 mg/m(2) (day 1-5) every 4 weeks. Kaplan-Meier estimates of overall survival (OS) were determined. Univariate analysis with log-rank test was used to determine the impact of prognostic variables on survival.

Results: Median age at presentation was 11.5 years (range: 7-19 years) and M:F ratio was 15:8. All patients underwent maximal safe surgical resection; 13 gross total resection and 10 sub-total resection. At a median follow-up of 18 months (range: 2.1-126 months), the estimated median OS was 41.9 months. The estimated median OS for patients receiving only concurrent TMZ was 8 months while that for patients receiving concurrent and adjuvant TMZ was 41.9 months (P = 0.081). Estimated median OS for patients who did not complete six cycles of adjuvant TMZ was 9.5 months versus not reached for those who completed at least six cycles (P = 0.0005). Other prognostic factors did not correlate with survival.

Conclusions: Our study shows the benefit of TMZ for pGBM patients. Both concurrent and adjuvant TMZ seem to be important for superior OS in this group of patients.

No MeSH data available.


Related in: MedlinePlus