Title: Comparative Study of Temozolamide with Concurrent RT vs. Tamoxifen Plus Temozolamide, Concurrent RT in GBM Patients
Authors: Dr Niharika Panda, Dr Samarendra Dash, Dr Lucy Pattanayak
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.137
Abstract
Glioblastoma Multiforme (GBM) the most common primary tumour arising in the human brainrepresent a formidable clinical challenge. Despite advances which have been made in conventional surgical, radio therapeutic and chemotherapeutic modalities, the prognosis of such patients remains poor. The present prospective study is aimed at comparing the toxicity profile in GBM patients receiving high dose of Tamoxifen, Temozolamide and RT and secondly comparing the response of GBM patients. Patients with GBM at post operative stage having ECOG performance 0, 1, 2; life expectancy of >8 weeks who attended a regional cancer centre in South Eastern India were included in the study. A total of 30 patients were studied and were divided to two arms arm ‘A’ and arm ‘B’. External beam radiotherapy by cobalt 60 Theratron 780C was given at a dose of 60Gy in 30 fraction per week. Temozolamide was given in dose of 75mg/m2 from day one to day 30 one hour before food and one hour before RT at the same time every day. Tamoxifen was given at dose of 40mg/m2/day from day 1 to day 30 before food in the morning hours. Toxicity was assessed using RTOG and common toxicity criteria. Both toxicity and response was evaluated during RT, six weeks after RT and subsequently at 3 months and 6 months of follow up. It was observed that high dose of Tamoxifen is well tolerated. Gastrointestinal and neurological toxicity were little higher and of grade 1 and 2. No retinopathy was observed. In Tamoxifen arm most patients showed partial response with stable disease.
Keywords- Glioblastoma Multiforme (GBM), Tamoxifen, Temozolamide, RT.
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