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- Title
Continuous Low-Dose Temozolomide Chemotherapy and Microvessel Density in Recurrent Glioblastoma.
- Authors
Jong-Yun Woo; Seung Ho Yang; Youn Soo Lee; Su Youn Lee; Jeana Kim; Yong Kil Hong
- Abstract
Objective : The purpose of this study was to evaluate the clinical efficacy of continuous low-dose temozolomide (TMZ) chemotherapy for recurrent and TMZ-refractory glioblastoma multiforme (GBM) and to study the relationship between its efficacy and microvessel density within the tumor. Methods : Thirty patients who had recurrent GBM following Stupp's regimen received TMZ daily at 50 mg/m²/day until tumor progression between 2007 and 2013. The median duration of continuous low-dose TMZ administration was 8 weeks (range, 2-64). Results : The median progression-free survival (PFS) of continuous low-dose TMZ therapy was 2 months (range, 0.5-16). At 6 months, PFS was 20%. The median overall survival (OS) from the start of this therapy to death was 6 months (95% CI : 5.1-6.9). Microvessel density of recurrent tumor tissues obtained by reoperation of 17 patients was 22.7±24.1/mm² (mean±standard deviation), and this was lower than that of the initial tumor (61.4±32.7/mm²) (p-value=0.001). It suggests that standard TMZ-chemoradiotherapy reduces the microvessel density within GBM and that recurrences develop in tumor cells with low metabolic burden. The efficacy of continuous low-dose TMZ could not be expected in recurrent GBM cells in poor angiogenic environments. Conclusion : The efficacy of continuous low-dose TMZ chemotherapy is marginal. This study suggests the need to develop further treatment strategies for recurrent and TMZ-refractory GBM.
- Subjects
TEMOZOLOMIDE; CANCER chemotherapy; GLIOBLASTOMA multiforme treatment; DRUG efficacy; CANCER invasiveness; DRUG dosage; THERAPEUTICS
- Publication
Journal of Korean Neurosurgical Society, 2015, Vol 58, Issue 5, p426
- ISSN
2005-3711
- Publication type
Article
- DOI
10.3340/jkns.2015.58.5.426