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Survival analysis of patients with glioblastoma treated by long-term administration of temozolomide.

Al's Comment:

 This is the reason why we like to see prospective trials.  In this retrospective study, they looked at people who used Temodar for 6 months or less versus people who received more than 6 months of Temodar.  The progression free survival was a little better but the overall survival was more than double (47 vs 20 months) in the long term group vs. the short term group. That would be very impressive except they did not give one group 6 months of Temodar and the other group more than 6. They just looked back to see how long patients used it.  It is possible that the patients who used it longer were the ones in good shape and who were responding to it and the ones who stopped at or before 6 months did so because they were having problems, in which case you would expect the group doing well to live longer than the group not doing well.

Posted on: 01/09/2020

. Medicine (Baltimore). 2020 Jan;99(2):e18591. doi: 10.1097/MD.0000000000018591.
Survival analysis of patients with glioblastoma treated by long-term administration of temozolomide.
Quan R1, Zhang H2, Li Z1, Li X1.
Author information:
1. Department of Radiation Oncology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital.
2. Department of Endocrinology, Hospital of Southern University of Science and Technology, Shenzhen, China.
This analysis aimed to investigate whether the long-term administration of temozolomide (TMZ) claimed a survival advantage for patients with glioblastoma in China.A total of 75 patients with newly diagnosed glioblastoma at the Department of Radiation Oncology, Shenzhen People's Hospital between August 2008 and August 2016 were retrospectively evaluated during analysis. A propensity-matched analysis was performed to balance the basic characteristics of patients between compared groups. Kaplan-Meier method and Cox proportional hazards model were used to assess progression-free survival (PFS) and overall survival (OS) of patients receiving 6 adjuvant TMZ cycles compared with patients treated with more than 6 cycles.Twenty of 75 patients received more than 6 cycles of TMZ, and the other 55 patients were treated with a median of 6 cycles ranging from 1 to 6. The patients with long-term administration of TMZ had better OS (47.0 months, 95% CI 20.0-73.9 vs 20.6 months, 95% CI 17.9-23.2, P?=?.014) but not PFS (17.0 months, 95% CI 10.1-24.5 vs 14.2 months, 95% CI 11.8-16.6, P?=?.133). Balancing the clinical factors with a propensity-matched analysis also showed the significant advantage of prolonged TMZ application in terms of OS but not PFS.Prolonged administration of TMZ beyond 6 cycles did demonstrate survival benefits for patients with initially diagnosed glioblastoma.
PMID: 31914038 


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