mdlinx mdlinx
Latest (413) Full Text Articles (5583) Article Summary

Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly
The Lancet Oncology,  Clinical Article

Wick W et al. – Temozolomide alone is non–inferior to radiotherapy alone in the treatment of elderly patients with malignant astrocytoma. MGMT promoter methylation seems to be a useful biomarker for outcomes by treatment and could aid decision–making.

Methods
  • Between May 15, 2005, and Nov 2, 2009, the authors enrolled patients with confirmed anaplastic astrocytoma or glioblastoma, age older than 65years, and a Karnofsky performance score of 60 or higher.
  • Patients were randomly assigned 100mg/m2 temozolomide, given on days 1-7 of 1week on, 1week off cycles, or radiotherapy of 60.0Gy, administered over 6-7weeks in 30 fractions of 1.8-2.0Gy.
  • The primary endpoint was overall survival.
  • They assessed non-inferiority with a 25% margin, analysed for all patients who received at least one dose of assigned treatment.

Results
  • Of 584 patients screened, the authors enrolled 412.
  • 373 patients (195 randomly allocated to the temozolomide group and 178 to the radiotherapy group) received at least one dose of treatment and were included in efficacy analyses.
  • Median overall survival was 8.6months (95% CI 7.3-10.2) in the temozolomide group versus 9.6months (8.2-10.8) in the radiotherapy group (hazard ratio [HR] 1.09, 95% CI 0.84-1.42, pnon-inferiority=0.033).
  • Median event-free survival (EFS) did not differ significantly between the temozolomide and radiotherapy groups (3.3months [95% CI 3.2-4.1] vs 4.7 [4.2-5.2]; HR 1.15, 95% CI 0.92-1.43, pnon-inferiority=0.043).
  • Tumour MGMT promoter methylation was seen in 73 (35%) of 209 patients tested.
  • MGMT promoter methylation was associated with longer overall survival than was unmethylated status (11.9months [95% CI 9.0 to not reached] vs 8.2months [7.0-10.0]; HR 0.62, 95% CI 0.42-0.91, p=0.014).
  • EFS was longer in patients with MGMT promoter methylation who received temozolomide than in those who underwent radiotherapy (8.4months [95e% CI 5.5—11.7] vs 4.6 [4.2—5.0]), whereas the opposite was true for patients with no methylation of the MGMT promoter (3.3 months [3.0-3.5] vs 4.6months [3.7-6.3]).
  • The most frequent grade 3-4 intervention-related adverse events were neutropenia (16 patients in the temozolomide group vs two in the radiotherapy group), lymphocytopenia (46 vs one), thrombocytopenia (14 vs four), raised liver-enzyme concentrations (30 vs 16), infections (35 vs 23), and thromboembolic events (24 vs eight).

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Nursing

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Nursing Articles

Last month's top read Top Articles of 2013

1 Ticks may cause double trouble, Stanford scientists find Full Text EurekAlert!, February 21, 2014    Free full text

2 'Putting the next generation of brains in danger' Full Text CNN Health, February 18, 2014    Free full text

3 How grazing affects your digestive function U.S. News & World Report - Health, January 30, 2014

4 A meta-analysis of coffee intake and risk of urolithiasis Urologia Internationalis, February 7, 2014    Clinical Article

5 Personal health: tackling menopauses side effects The New York Times, February 12, 2014

6 Yogurt consumption and impact on health: focus on children and cardiometabolic risk American Journal of Clinical Nutrition, March 21, 2014    Review Article

7 Long-term coffee consumption and risk of cardiovascular disease Circulation, February 11, 2014    Evidence Based Medicine    Review Article    Clinical Article

8 Tea consumption and leukemia risk: A meta-analysis Tumor Biology, February 12, 2014    Evidence Based Medicine    Clinical Article

9 Coffee intake and gastric cancer risk Cancer Epidemiology, Biomarkers & Prevention, March 19, 2014    Clinical Article

10 Effects of pomegranate juice consumption on inflammatory markers in patients with type 2 diabetes: A randomized, placebo-controlled trial Journal of Research in Medical Sciences, March 20, 2014    Clinical Article

11 Egg consumption and cardiovascular disease among diabetic individuals: A systematic review of the literature Full Text Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, March 28, 2014    Free full text    Review Article

12 Could you relationship with your mom increase your childs chances of obesity? Full Text EurekAlert!, February 3, 2014    Free full text

13 Coffee consumption and prostate cancer risk: An updated meta-analysis Cancer Causes and Control, March 3, 2014    Evidence Based Medicine    Clinical Article

14 Heated vegetable oils and cardiovascular disease risk factors Vascular Pharmacology, March 20, 2014    Review Article

15 Animal protein intake is associated with higher-level functional capacity in elderly adults: The Ohasama study Journal of the American Geriatrics Society, March 5, 2014    Clinical Article

16 Coffee consumption and risk of prostate cancer: A meta-analysis of prospective cohort studies Carcinogenesis, January 17, 2014    Evidence Based Medicine    Review Article

17 Vascular dysfunction and chronic obstructive pulmonary disease Hypertension, February 26, 2014    Clinical Article

18 Egg consumption and risk of GI neoplasms: dose–response meta-analysis and systematic review European Journal of Nutrition, February 6, 2014    Evidence Based Medicine    Review Article

19 Effects of yoga on cardiovascular disease risk factors: A systematic review and meta-analysis International Journal of Cardiology, March 17, 2014    Evidence Based Medicine    Review Article    Clinical Article

20 Is ginger effective for the treatment of irritable bowel syndrome? A double blind randomized controlled pilot trial Complementary Therapies in Medicine, March 4, 2014    Clinical Article

Indexed Journals in Nursing: Journal of Advanced Nursing, Journal of Clinical Nursing, Nurse Education In Practicemore

Other Topics in Nursing

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Stay current - Media Tool

Newsletter
RSS
Follow
Like

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close