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Suez Canal University Medical Journal SCU-MJ

The Official Journal of Faculty of Medicine, Suez Canal University

Founded in 1998

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Current Issue Article, Volume 21, Issue 1, March 2018

Comparative Study between Concomitant Radiotherapy With Temozolamide Versus Concomitant Radiotherapy With Etoposide and Mannitol in Glioblastoma Multiforme

Mohamed F. Abosree*, Maha L. Zamzam, Sohier A. Abdelmohsen, Ehab M. Hassanin


Background: Glioblastoma multiforme has the worst prognosis of all central nervous system malignancy, despite multimodality treatment. Prognosis is poor, with a median survival of 3 months from the time of diagnosis without treatment, that increased to 1–2 years with treatment. Treatment of glioblastoma multiforme in Egypt is varied between different centers due to different radiotherapy machines and the available chemotherapy. Due to the high cost of chemotherapy (Temozolamide), we aimed in this study to introduce a more cost-effective chemotherapy agent (Etoposide) Aim: To compare between (concomitant radiotherapy/Temozolamide followed by Temozolamide) and (concomitant radiotherapy/Etoposide/Mannitol followed by Etoposide plus Mannitol) in treatment of patients with glioblastoma multiforme. Patient and Methods: the study included all patients presented with glioblastoma multiforme (proved pathologically) in clinical oncology and nuclear medicine department of Suez Canal university hospital. Patients were divided into two groups: Group A: patients who received the standard treatment of glioblastoma multiforme (concomitant radiotherapy/temozolamide followed by temozolamide) (n=17). Group B: patients received concomitant radiotherapy/Etoposide/mannitol followed by Etoposide and mannitol (n=17). Both groups were matched regarding dosage and duration of radiotherapy. Results: the median age of all patients was 38 years, female/male ratio 1.2. PFS and OS were insignificantly longer with concomitant radiotherapy and temozolomide group than with concomitant radiotherapy with Etoposide plus mannitol (median PFS, 6 v 5 months, respectively; median OS, 14 months in both groups). Conclusion: comparable results regarding efficacy, progression-free and overall survival between the two groups. This result suggests that the regimen of combination (etoposide with mannitol) has comparable results with temozolomide for glioblastoma patients. Keywords: brain tumor; overall survival; Blood-Brain Barrier