• John M Watkins, David T Marshall, Sunil Patel, Pierre Giglio, Amy E Herrin, Elizabeth Garrett-Mayer, and Joseph M Jenrette.
• Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 29425, USA.
• J. Neurooncol. 2009 Jul 1; 93 (3): 343-8.

ObjectivesTo describe outcomes associated with high-dose radiotherapy with and without temozolomide for high grade central nervous system (CNS) neoplasms.MethodsRetrospective chart review of 60 patients diagnosed with malignant glioma treated with > or =70 Gy radiotherapy.ResultsMedian age at diagnosis was 52 years, and 52 patients had astrocytomas (38 glioblastomas). Median prescribed radiotherapy dose was 78 Gy (range 70-80), and 29 patients received concurrent temozolomide. Eighty-six percent completed the planned course treatment. Three patients experienced RTOG grade 3 acute CNS toxicity; late brain necrosis was suspected in four patients. Overall median survival was 13 months (range 2-83). Within glioblastoma patients, temozolomide provided a statistically significant survival improvement over no chemotherapy (median survival 12.7 vs. 7.5 months; P = 0.0058).ConclusionsHigh dose conformal radiotherapy to > or =70 Gy with chemotherapy for high-grade CNS neoplasms appears safe but survival remains suboptimal. Within glioblastoma patients, temozolomide provided statistically significant survival improvement over no chemotherapy.

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