Guideline conformity to the Stupp regimen in patients with newly diagnosed glioblastoma multiforme in China
Aims: To determine how consistently Chinese glioblastoma multiforme (GBM) patients were treated according to the Stupp regimen. Patients and methods: The proportion of treatments conforming to the Stupp regimen and reasons for non-conformity were evaluated in 202 newly diagnosed GBM patients. Results: Only 15.8% GBM patients received treatments compliant with the Stupp regimen. Main deviations were temozolomide dosages >75 mg/m2 (58/120, 48.3%) and treatment durations <42 days (84/120, 70.0%) in the concomitant and temozolomide dosages <150 mg/m2 (89/101, 88.1%) in the maintenance phase. Median OS (27.09 vs 18.21 months) and PFS (14.27 vs 12.10 months) times were longer in patients who received Stupp regimen compliant treatments. Conclusion: Increased conformity to the Stupp regimen is needed for GBM patients in China.
In 2005, the European Organization for Research and Treatment of Cancer (EORTC) 26981 study led to Food and Drug Administration (FDA) approval for the use of temozolomide (TMZ) in combination with radiotherapy to treat glioblastoma multiforme (GBM). The Stupp regimen consists of fractionated focal irradiation in daily fractions of 2 Gy given 5 days/week for 6 weeks with a total of 60 Gy, plus concomitant daily TMZ (75 mg/m2/day, 7 days/week from the first to the last day of radiotherapy), followed by 6 cycles of adjuvant TMZ (150–200 mg/m2/day for 5 days during each 28-day cycle). In 2012 the “Guidelines for the Diagnosis and Treatment of Glioma of the Central Nervous System in China recommended the Stupp regimen as first-line therapy for newly diagnosed GBM. In the present study, compliance of GBM treatments with the Stupp regimen in 28 Chinese centers from 2012-2016 were evaluated. As a result, only 15.8% GBM patients received treatments compliant with the Stupp regimen. Main deviations included the correct temozolomide dosages and treatment durations in the concomitant and maintenance phases. Median overall survival (27.09 vs 18.21 months) and progression free survival (14.27 vs 12.10 months) times were longer in patients who received Stupp regimen compliant treatments.
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