Abstract
Glioblastoma multiforme (GBM) is one of the most malignant CNS tumors. Despite advances in treatment modalities, it remains largely incurable. Several studies show that there is a promising survival advantage in treatment of GBM with extended temozolamide as compared to standard adjuvant six cycles.
Aim To evaluate the impact of extended 12 versus standard6 cycles of adjuvant temozolamide (TMZ) on overall survival and progression free survival in glioblastoma multiform patients.
Patient and method The study was conducted on 40 patients with newly diagnosed glioblastoma referred to the Clinical Oncology & Nuclear Medicine Department, Zagazig University Hospitals between January2018,and January 2020 The patients were divided in two arms: Arm A included 20 patients treated by radiotherapy at a dose 60Gy/30fraction concurrently with TMZ for 6cycles(conventional TMZ)compared with Arm B that included 20 patients treated by the same concurrent chemo-radiotherapy regimen followed by 12 cycles adjuvant TMZ (extended TMZ).

RESULTS
Median progression
free survival (PFS) was7.3 months and 5.6 months in extended TMZ and conventional TMZ respectively.Median overall survival (OS) was 12.4 months versus 10.8 in extended TMZ and conventional toxicity in extended TMZ and conventional TMZ respectively.
Conclusion The study showed that extended TMZ is well tolerated and lead to increase in PFS and OS in treatment of GBM but not statically significant. Further studies are needed to evaluate the extended treatment protocol.