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BioMed Research International
Volume 2017, Article ID 9461402, 7 pages
Research Article

Patients Affected by Unmethylated O(6)-Methylguanine-DNA Methyltransferase Glioblastoma Undergoing Radiochemotherapy May Benefit from Moderately Dose-Escalated Radiotherapy

1Sbarro Health Research Organization, Temple University, Philadelphia, PA, USA
2Unit of Radiation Oncology, University Hospital of Siena, Siena, Italy
3Department of Medicine, Surgery and Neurological Sciences, University of Siena, Siena, Italy
4Unit of Pathological Anatomy, Department of Medicine, Surgery and Neurological Sciences, University of Siena, Siena, Italy
5Unit of Neuroradiology, University Hospital of Siena, Siena, Italy

Correspondence should be addressed to Paolo Tini; ti.orebil@init-oloap

Received 6 June 2017; Accepted 9 August 2017; Published 12 October 2017

Academic Editor: Nader Pouratian

Copyright © 2017 Paolo Tini et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To compare the therapeutic results of two radiotherapy (RT) dose schedules in combined temozolomide- (TMZ-) RT treatment in newly diagnosed glioblastoma (GB), according to the O(6)-methylguanine-DNA methyltransferase (MGMT) methylation status. Material and Method. Patients received either standard (60 Gy) or moderately escalated dose (70 Gy) radiotherapy (RT) with concomitant and adjuvant TMZ between June 2006 and October 2013. We retrospectively evaluated the therapeutic effectiveness of RT schedules in terms of Overall Survival (OS) and Progression-Disease Free Survival (PDFS) analyzing the MGMT methylation status. Results. One hundred and seventeen patients were selected for the present analysis. Seventy-two out of the selected cases received the standard RT-TMZ course (SDRT-TMZ) whereas the remaining 45 underwent the escalated schedule (HDRT-TMZ). The analysis according to the MGMT promoter methylation status showed that, in unmethylated-MGMT GB patients, HDRT-TMZ and SDRT-TMZ groups had different median OS () and PDFS (), that is, 8 months and 5 months for the SDRT-TMZ group and 14 months and 9 months for the HDRT-TMZ group, respectively. No difference in survival outcomes was found in methylated MGMT patients according to the two RT schedules (). Conclusions. In our experience, unmethylated-MGMT GB patients benefited from a moderately escalated dose of RT plus TMZ.