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- W2099413120 abstract "Glioblastoma (GBM) is a devastating disease with a 1 yr median survival. The addition of temozolomide (TMZ) to radiation has led to improved survival, but additional radiosensitizing agents are needed. Current supportive treatment often includes the use of antiepileptic drugs, some of which, such as valproic acid (VA), have been shown to exhibit histone deacetylase (HDAC) inhibitor activity with a potential role in radiation sensitization. We hypothesized that patients with GBM treated with these drugs during the course of their radiotherapy would exhibit improved outcomes. Clinical records were examined retrospectively in patients diagnosed with GBM between 1996 and 2006 from our institution. Outcomes included overall survival (OS), progression-free survival (PFS), and radiation response. PFS was determined based on the radiographically apparent tumor progression. RT response was scored based on a comparison of the amount of residual enhancement between the pre- and post-RT MRIs. Initially, the use of VA, for which a pre-clinical role in radiosensitization has been demonstrated, was analyzed separately. Additional antiepileptic agents with known HDAC inhibitory effects were then examined together with valproic acid. Data for 269 patients were available for analysis with a median age of 58 y. Median OS and PFS for the cohort were 62 weeks and 20 weeks, respectively. RT response ranging from stable enhancement to a >50% decrease in the size of enhancement among subtotally resected patients was seen in 115 (43%) of cases. Concurrent TMZ was given to 142 patients (53%). Sixteen patients (6%) received VA during the course of their treatment. Other antiepileptic agents were given in 175 cases and included phenytoin (69%), levetiracetam (19%), and carbamazepine (7%). No significant benefit in OS, PFS, or RT response was seen for patients receiving VA. Median OS and PFS for the VA receiving group was 64 wks and 22 wks, respectively, compared to 63 wks and 19 wks, respectively, for the no-VA group. Eight patients (50%) of the VA group showed a response to RT compared to 107 (44%) in the non-VA group (p = NS). When patients receiving VA were combined with those receiving other HDAC inhibitory antiepileptic drugs (n = 51), the results were similarly not significant for all outcomes. Among the subset of patients receive TMZ, HDAC inhibitors resulted in a modest, but not statistically significant improvement in median OS (62 wks vs. 48 wks, p = 0.18), but no difference in PFS or RT response. The use of antiepileptic, HDAC inhibiting drugs during radiotherapy for GBM did not improve outcome in this retrospective analysis. While potentially beneficial, further study is needed to determine a benefit for the combination of TMZ and HDAC inhibitors." @default.
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- W2099413120 date "2008-09-01" @default.
- W2099413120 modified "2023-09-26" @default.
- W2099413120 title "Analysis of Patients Receiving Histone Deacetylase Inhibiting Antiepileptic Agents during Radiation Treatment for Glioblastoma" @default.
- W2099413120 doi "https://doi.org/10.1016/j.ijrobp.2008.06.696" @default.
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