Glioblastomas and Chemotherapy with Temozolamide

G.L. Kobyakov*, V.I. Borisov**, O.V. Absalyamova*, R.D. Amanov*, A.G. Korshunov*, A.V. Golanov*

* Burdenko Research Institute of Neurosurgery, Moscow, Russia
** Oncologic Clinical Hospital N1 Moscow, Russia

 

Treatment of cases with cerebral glioblastomas is one of the unsolved problems of neurooncology. Median survival after radiotherapy, applied postoperatively, is 12 months. The results of the international multi-center randomized trial (Phase III), aimed at comparison of combined use of radio- and chemotherapy with temozolamide and only radiotherapy in cases with glioblastomas, were published in 2005. They were indicative of statistically reliable increase of relapse-free and total survival in combined use of radio- and chemotherapy with timozolamide in comparison with radiotherapy as an adjuvant method of treatment after glioblastoma removal.

There were 48 cases with initially diagnosed glioblastomas, treated by the employees of the Institute of Neurosurgery in collaboration with specialists of oncologic outpatient departments of Moscow. Their age varied from 18 to 67 years (the median of 51 years). Treatment, carried out after operation, consisted in radiotherapy (total irradiation dose of 60 Gy, 30 fractions) and simultaneous chemotherapy with temozolamide (a daily dose of 75 mg/m2). When radiotherapy was over, chemotherapy with temozolamide (a daily dose of 200 mg/m2) was carried out during 5 days. Such courses were repeated every 28 days; their total number varied from 6 up to 10.

The median of total survival was 17.7 months (0.2-26.7 months); 17 cases (35%) had died by the moment of data analysis. We continued to follow up the rest 31 cases (65%). The median relapse-free period was 9.7 months (1.3-26.7 months).

Conclusion. The obtained indices of survival were considerably higher than those, watched when radiotherapy was the only means of postoperative treatment. Thus, it must be admitted, that use of this treatment mode as a standard method in the leading countries of the world is justified.