NCMP-30. OUTCOME OF CONCOMITANT CHEMORADIATION WITH TEMOZOLOMIDE FOLLOWED BY TEMOZOLOMIDE IN PATIENTS WITH GLIOBLASTOMA MULTIFORME

Glioblastoma is the most common primary brain tumor in adults. The current standard of care is multimodal approach comprising of maximal safe surgical resection, post-operative radiation therapy (RT), and concurrent and adjuvant temozolomide (TMZ). To date, no published data are available for the outcome of this disease treated with standard of care in Pakistan. In this study results of concomitant chemoradiation with 5 days of temozolomide followed by temozolomide has been reported. To determine Progression Free Survival (PFS) and Overall Survival (OS) in patient’s receiving concomitant chemoradiation with 5 days of temozolomide followed by temozolomide in newly diagnosed GBM. Patients with newly diagnosed glioblastoma were assigned to receive concomitant chemoradiation with temozolomide (75mg/m2) 5 days per week on the days of radiation. After a 4-week break, patients then received monthly temozolomide (150-200mg/m2) 5-day schedule every 28 days. From June 2011 to June 2016, 58 patients with newly diagnosed GBM were included in the study. Median age was 54 years, 71% (n=41) were male, whereas 29% (n=17) were female. 57% (n=33) underwent subtotal resection, 33% (n=19) had gross total resection while 10% (n=6) underwent biopsy only. About 64% (n=37) completed standard of care concomitant chemoradiation followed by monthly TMZ.36 % (n=21) completed only concomitant chemoradiation and were lost to follow. At a median follow up of 1 year, median PFS and OS was 8 and 13 months respectively with chemoradiation followed by TMZ. In subgroup analysis median PFS and OS benefit was more in patients who underwent maximal safe resection as compared to biopsy. This study confirmed that PFS and OS benefit was more in patients who completed concomitant chemoradiation followed by monthly TMZ. OS benefit was almost similar with 5 days of TMZ as opposed with 7 days of TMZ as reported in international study.