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High-dose radiotherapy to 78 Gy with or without temozolomide for high grade gliomas

  • Clinical study - patient study
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Abstract

Objectives To describe outcomes associated with high-dose radiotherapy with and without temozolomide for high grade central nervous system (CNS) neoplasms. Methods Retrospective chart review of 60 patients diagnosed with malignant glioma treated with ≥70 Gy radiotherapy. Results Median age at diagnosis was 52 years, and 52 patients had astrocytomas (38 glioblastomas). Median prescribed radiotherapy dose was 78 Gy (range 70–80), and 29 patients received concurrent temozolomide. Eighty-six percent completed the planned course treatment. Three patients experienced RTOG grade 3 acute CNS toxicity; late brain necrosis was suspected in four patients. Overall median survival was 13 months (range 2–83). Within glioblastoma patients, temozolomide provided a statistically significant survival improvement over no chemotherapy (median survival 12.7 vs. 7.5 months; P = 0.0058). Conclusions High dose conformal radiotherapy to ≥70 Gy with chemotherapy for high-grade CNS neoplasms appears safe but survival remains suboptimal. Within glioblastoma patients, temozolomide provided statistically significant survival improvement over no chemotherapy.

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Authors and Affiliations

  1. Department of Radiation Oncology, Medical University of South Carolina, 169 Ashley Avenue, MSC 318, Charleston, SC, 29425, USA

    John M. Watkins, David T. Marshall & Joseph M. Jenrette III

  2. Department of Neurosciences – Division of Neurosurgery, Medical University of South Carolina, 169 Ashley Avenue, MSC 318, Charleston, SC, 29425, USA

    Sunil Patel

  3. Department of Neurosciences – Division of Neurology, Medical University of South Carolina, 169 Ashley Avenue, MSC 318, Charleston, SC, 29425, USA

    Pierre Giglio

  4. Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, 169 Ashley Avenue, MSC 318, Charleston, SC, 29425, USA

    Amy E. Herrin & Elizabeth Garrett-Mayer

Authors
  1. John M. Watkins
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  2. David T. Marshall
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  3. Sunil Patel
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  4. Pierre Giglio
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  5. Amy E. Herrin
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  6. Elizabeth Garrett-Mayer
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  7. Joseph M. Jenrette III
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Correspondence to David T. Marshall.

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Watkins, J.M., Marshall, D.T., Patel, S. et al. High-dose radiotherapy to 78 Gy with or without temozolomide for high grade gliomas. J Neurooncol 93, 343–348 (2009). https://doi.org/10.1007/s11060-008-9779-y

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  • DOI: https://doi.org/10.1007/s11060-008-9779-y

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