J Korean Med Sci.  2006 Aug;21(4):739-744. 10.3346/jkms.2006.21.4.739.

Temozolomide Chemotherapy in Patients with Recurrent Malignant Gliomas

• Yang SH
• Kim MK
• Lee TK
• Lee KS
• Jeun SS
• Park CK
• Kang JK
• Kim MC
• Hong YK

• KMID: 2157831
• DOI: http://doi.org/10.3346/jkms.2006.21.4.739

Abstract

Numerous studies have demonstrated the clinical activity of temozolomide, a second-generation alkylating agent, against malignant brain tumors, however, its activity has not been reported in an Asian population. This study analyzed the efficacy and toxicity of temozolomide in 25 adult patients with recurrent or progressive malignant gliomas after surgery and standard radiation therapy with or without chemotherapy, enrolled in our institution since July 2000. Sixteen patients had glioblastoma multiforme (GBM), six with anaplastic astrocytoma, and three with anaplastic oligodendroglioma. Of the 25 patients, 3 (12%) achieved a complete response (CR), 8 (32%) achieved a partial response (PR), 6 (24%) had stable disease (SD), and 8 (32%) had progressive disease (PD). Two patients achieved a CR, 4 patients achieved a PR, 3 patients had SD and 7 patients had PD in GBM, and 1 patient achieved a CR, 4 patients achieved a PR, 3 patients had SD, 1 patient had PD in the non-GBM patients. Median progression free survival was 8 weeks in GBM and 22 weeks in the non-GBM patients. The median overall survival of each group was 17 weeks and 28 weeks. Temozolomide demonstrated moderate activity in recurrent and progressive malignant gliomas without serious toxicity.

Keyword

Glioma; Drug Therapy; Recurrence; temozolomide

MeSH Terms

Vomiting/chemically induced
Treatment Outcome
Survival Analysis
Neoplasm Recurrence, Local
Nausea/chemically induced
Middle Aged
Male
Magnetic Resonance Imaging
Liver Diseases/chemically induced
Leukopenia/chemically induced
Humans
Glioma/*drug therapy/radiotherapy/surgery
Female
Drug Administration Schedule
Dacarbazine/administration & dosage/adverse effects/*analogs & derivatives/therapeutic use
Combined Modality Therapy
Brain Neoplasms/*drug therapy/radiotherapy/surgery
Brain/drug effects/pathology
Antineoplastic Agents, Alkylating/administration & dosage/adverse effects/therapeutic use
Adult
Adolescent
Administration, Oral

Figure

• 

  Fig. 1 Pre-chemotherapy MR image (A) and MR image after three courses of temozolomide (B) of a patient with a grade 4 glioma, consistent with a partial response.

• 

  Fig. 2 Pre-chemotherapy MR image (A) showing ill-defined lesion involving the posterior portion of the corpus callosum of a patient with a grade 3 glioma. Non-enhanced CT scan (B) and enhanced CT scan (C) after fourteen cycles of temozolomide, consistent with a complete response.

• 

  Fig. 3 Kaplan-Meier survival curve in glioblastoma and non-glioblastoma patients.

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