PURPOSE: Although TMZ replaced BCNU as the standard initial chemotherapy in the treatment of GBM, no studies have been reported comparing BCNU with TMZ. We therefore did a retrospective analysis comparing these agents as initial therapy in GBM. PATIENTS AND METHODS: Eighty-one patients with GBM in our institution received both radiation and chemotherapy as initial treatment after surgery or biopsy; 49 receiving BCNU and 32 TMZ. These were analyzed for overall survival (OS) and progression-free survival (PFS) versus the type of chemotherapy used. The influence of salvage therapy on the outcome was investigated also. RESULTS: Median OS was superior in the TMZ versus the BCNU group (15.9 vs. 11.5 months) and the curves were judged to be significantly different by the log-rank test; P < 0.02. However, PFS was not significantly different between the two groups. Bevacizumab plus irinotecan (BI) was used as salvage therapy in one-third of the TMZ patients but in none of the BCNU patients. When patients receiving BI were omitted from the TMZ group the OS curve overlapped that of BCNU patients. CONCLUSION: These data suggest that the superior OS of the TMZ-treated GBM patients was not due to better tumor control by TMZ but was possibly related to the newer salvage therapy that was available to them.
PURPOSE: Although TMZ replaced BCNU as the standard initial chemotherapy in the treatment of GBM, no studies have been reported comparing BCNU with TMZ. We therefore did a retrospective analysis comparing these agents as initial therapy in GBM. PATIENTS AND METHODS: Eighty-one patients with GBM in our institution received both radiation and chemotherapy as initial treatment after surgery or biopsy; 49 receiving BCNU and 32 TMZ. These were analyzed for overall survival (OS) and progression-free survival (PFS) versus the type of chemotherapy used. The influence of salvage therapy on the outcome was investigated also. RESULTS: Median OS was superior in the TMZ versus the BCNU group (15.9 vs. 11.5 months) and the curves were judged to be significantly different by the log-rank test; P < 0.02. However, PFS was not significantly different between the two groups. Bevacizumab plus irinotecan (BI) was used as salvage therapy in one-third of the TMZpatients but in none of the BCNUpatients. When patients receiving BI were omitted from the TMZ group the OS curve overlapped that of BCNUpatients. CONCLUSION: These data suggest that the superior OS of the TMZ-treated GBM patients was not due to better tumor control by TMZ but was possibly related to the newer salvage therapy that was available to them.
Authors: James J Vredenburgh; Annick Desjardins; James E Herndon; Jennifer Marcello; David A Reardon; Jennifer A Quinn; Jeremy N Rich; Sith Sathornsumetee; Sridharan Gururangan; John Sampson; Melissa Wagner; Leighann Bailey; Darell D Bigner; Allan H Friedman; Henry S Friedman Journal: J Clin Oncol Date: 2007-10-20 Impact factor: 44.544
Authors: V A Levin; W M Wara; R L Davis; P Vestnys; K J Resser; K Yatsko; S Nutik; P H Gutin; C B Wilson Journal: J Neurosurg Date: 1985-08 Impact factor: 5.115
Authors: D F Nelson; D Schoenfeld; A S Weinstein; J S Nelson; T Wasserman; R L Goodman; S Carabell Journal: Int J Radiat Oncol Biol Phys Date: 1983-08 Impact factor: 7.038
Authors: Robert Dubrow; Amy S Darefsky; Daniel I Jacobs; Lesley S Park; Michal G Rose; Maxwell S H Laurans; Joseph T King Journal: Neuro Oncol Date: 2013-09-17 Impact factor: 12.300