Clinical Research Papers:
Radiation combined with temozolomide contraindicated for young adults diagnosed with anaplastic glioma
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Pei Yang1,2,*, Chuanbao Zhang2,*, Jinquan Cai9, Gan You1,2, Yinyan Wang1,2, Xiaoguang Qiu3, Shouwei Li5, Chenxing Wu5, Kun Yao6, Wenbin Li7, Xiaoxia Peng10, Wei Zhang1,2 and Tao Jiang2,4,8
1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
3 Department of Radiation Therapy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
4 China National Clinical Research Center for Neurological Diseases, Beijing, China
5 Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China
6 Department of Pathology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China
7 Department of Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
8 Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China
9 Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
10 Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China
* The first two authors contributed equally to this work
Wei Zhang, email:
Tao Jiang, email:
Keywords: high-grade glioma, young adult, radiation, temozolomide, survival
Received: November 16, 2015 Accepted: August 22, 2016 Published: August 31, 2016
Purpose: Age is a major prognostic factor for malignant gliomas. However, few studies have investigated the management of gliomas in young adults. We determined the role of survival and treatment in young adults with advanced gliomas in a large population from the Chinese Glioma Genome Atlas (CGGA).
Methods: This study included 726 adults (age ≥ 18) with histologically proven anaplastic glioma or glioblastoma multiforme (GBM). The overall and progression-free survival was determined in young (age < 50) and older groups (age ≥ 50).
Results: The study included an older group (OP) of 264 patients and a younger group (YP) of 462patients. In the OP group with GBM and anaplastic glioma, patients treated with RT combined with temozolomide (TMZ) manifested significantly longer OS and PFS compared with patients assigned to RT alone (P < 0.05). In contrast, the YP group diagnosed with anaplastic glioma failed to show any survival advantage with RT plus TMZ compared with RT alone.
Conclusions: We observed no survival benefit in young adults (age < 50) with anaplastic glioma when treated with TMZ combined with RT. Our findings warrant further investigation of younger patients diagnosed with anaplastic glioma treated with radiotherapy plus TMZ chemotherapy.
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