Temozolomide chemotherapy combined with radiation therapy dramatically improves four-year survival for patients with glioblastoma multiforme compared with radiation alone, according to a plenary presentation at the annual meeting of the American Society for Therapeutic Radiology and Oncology.

Researchers found that more than four times as many patients lived four years after diagnosis, according to updated results of the large, international trial. Previously, patients only typically lived between 6 to 12 months after diagnosis, and there were almost no survivors beyond two years.

“A substantial number of patients with glioblastoma now have a good chance of surviving at least a few years now and of enjoying a productive life during this time, which was almost unthinkable less than a decade ago,” said Rene-Olivier Mirimanoff, MD, lead author of the study and a radiation oncologist at the Centre Hospitalier Universitaire Vaudois in Lausanne, Switzerland. “Considering how quickly this type of cancer grows, patients who live four or five years after diagnosis are indeed considered long-term cancer survivors.”

The phase III trial involved 573 patients who were randomized to temozolomide during and after radiation therapy or radiation alone. Combination treatment immediately became the standard treatment worldwide after two-year results were published in 2005 in the New England Journal of Medicine showing that twice as many patients who were treated with chemotherapy and radiation therapy survived two years after diagnosis compared with patients who received radiation alone.

Researchers extended the study to find out if patients who had combination treatment could live more than two years. Updated results show that 12 percent of patients who received chemotherapy during and after radiation treatment lived for four years compared with 3 percent of those who received radiation alone.

Findings also show that the main group of patients who survived for four years after diagnosis was less than 50 years old and in otherwise good health without any prior major medical condition (categorized as in RPA Class III). Over one-quarter (28 percent) of these patients who were treated with combination therapy lived for four years versus only 7 percent of patients who received only radiation therapy.

“Since patients with glioblastoma multiforme can now live longer, oncologists are monitoring them more closely and a substantial proportion of these patients are being actively treated when their cancer returns through a combination of treatment options,” said Mirimanoff. “This new management approach was extremely unlikely 10 years ago.”