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Acta Medica Colombiana
Print version ISSN 0120-2448
Abstract
VILLEGAS-MEJIA, Carlos Raúl; VILLEGAS-JARAMILLO, Manuel and VILLEGAS-JARAMILLO, Pedro. Temozolamide as an adjuvant in glioblastoma. How long? The experience of a cancer center in Colombia. Acta Med Colomb [online]. 2020, vol.45, n.4, pp.9-19. Epub June 08, 2021. ISSN 0120-2448. https://doi.org/10.36104/amc.2020.1325.
Introduction:
glioblastoma multiforme is considered to be highly lethal, for which the optimal duration of adjuvant temozolamide chemotherapy has not been determined.
Objective:
to evaluate survival according to the length of adjuvant chemotherapy based on the standard Stupp platform protocol.
Materials and methods:
a retrospective cohort analysis of 299 high-grade central nervous system tumors seen at Oncólogos del Occidente, focused solely on glioblastoma multiforme, according to clinical, treatment and outcome variables.
Results:
one hundred ninety-three patients with glioblastoma; 84 (44%) received standard Stupp platform treatment; mean age 54 years; 55% males; mean tumor size 28,793 mm2; 48% right hemisphere; 21% crossed the midline; 33% had seizures and 42% neurological deficit; 55% Karnofsky less than 70% and 66% RPA IV classification; 77% received radiation with 60.00 Gy or more; 19% had complications; 79% partial resection and 12% total resection; 77% relapsed; at closure, 57% were alive, global survival of 26% and mean of 26 months, with a difference of 31 months for adjuvance of <or> 6 months and 30 months for adjuvance of <or> 12 months, without reaching a median in the 18 and 24 month groups, all of them favoring the group with the longest time.
Conclusion:
a clear increase in survival is shown with adjuvant temozolamide for periods longer than six months, as well as a tendency towards better results with increased duration of adjuvance.
Keywords : central nervous system; tumor; glioblastoma; treatment; adjuvant chemotherapy; concomitance; survival.