Pre-radiation chemotherapy with ACNU-CDDP in patients with newly diagnosed glioblastoma: A retrospective analysis

Abstract

2067 Background: We evaluated the benefit of pre-radiation chemotherapy with ACNU(nimustine) plus CDDP(cisplatin) for patients with newly diagnosed glioblastoma by retrospective analysis. Methods: A total of 151 patients were newly confirmed to have glioblastoma between January 2000 and December 2004. All patients underwent surgical resection; complete resection in 38(25.2%), incomplete resection in 73(48.3%), and biopsy in 40(26.5%). Pre-radiation chemotherapy using ACNU-CDDP was administered as an initial adjuvant management for 87(57.6%) patients (ACNU-CDDP group), radiation therapy was performed in 31(20.5%) patients (RT group) and the rest 33 (21.9%) patients were treated with other regimens or refused further treatment. Results: The median survival time was 13 months (95% CI, 11.29–14.71), and the overall survival rate was 54.0% at 1 year, 21.3% at 2 years. Difference of the median survival time between complete resection group and biopsy group, and between ACNU-CDDP group and RT group was significant (15.0 months vs 10 months, p=0.028; 16.0 months vs 12.0 months, p=0.036) in the univariate analyses. Even in the multivariate analysis, pre-radiation chemotherapy using ACNU-CDDP showed significant effect on survival prolongation (HR=0.628, p=0.042). Usage of temozolomide for adjuvant or salvage management also had independent significant positive effect on the survival (HR=0.511, p=0.006). Grade 3 and 4 hematologic toxicities occurred in 28 (32.1%) patient of ACNU-CDDP group. However, there was no treatment-related death. Conclusions: Pre-radiation chemotherapy with ACNU-CDDP as an initial management is independently beneficial in survival prolongation with tolerable treatment-related toxicities in patients with newly diagnosed glioblastomas No significant financial relationships to disclose.