PURPOSE: For the last few years wafers of Gliadel have been inserted into the 
operation cavity in patients with glioblastoma multiforme. This is followed by 
concurrent radio-chemotherapy with temozolomide (TMZ) according to the Stupp 
protocol. Only a few studies have investigated this kind of treatment regimen 
and the impact in terms of survival and toxicity of the combination of Gliadel 
with TMZ and radiotherapy.
METHODS AND MATERIALS: From November 2006 to January 2010, 24 patients with a 
newly diagnosed glioblastoma have undergone a tumour resection which was 
considered to be macroscopically complete in 12 cases and with tumour residue in 
another 12 cases. The mean age at the moment of diagnosis was 60.25years and the 
median age 63. Twenty-three patients underwent subsequently concurrent 
radio-chemotherapy with TMZ followed by cycles of elevated doses of TMZ as an 
adjuvant treatment. One patient had adjuvant radiotherapy alone followed by 
adjuvant chemotherapy. Thirteen were able to receive 6 or more cycles of 
adjuvant TMZ. Seven patients had received less than 6 cycles of TMZ as an 
adjuvant therapy. Two patients did not receive adjuvant TMZ at all.
RESULTS: The median overall survival of our group was 19.2months and the median 
progression free survival was 12.3months. Overall survival for the 
macroscopically complete-resection patients was 14months, and 12.85months in 
subtotal-resection patients. The median OS was 14.25months for patients PS 0 - 1 
at the moment of diagnosis and 12.65 for PS 2 patients. Chemotherapy with TMZ 
had to be stopped prematurely in 10 cases due to haematotoxicity, digestive 
toxicity or early relapse.
CONCLUSIONS: The concomitant use of surgery with implantation of BCNU wafers and 
radio-chemotherapy seems to be well tolerated. Despite the small number of 
patients treated in our group, particular attention should be paid to the 
potential haematological consequences of this multimodal treatment regimen.