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- Title
Temozolomide for recurrent low-grade spinal cord gliomas in adults.
- Authors
Chamberlain, Marc C.
- Abstract
<bold>Background: </bold>There is no standard therapy for surgery- and radiotherapy-resistant, recurrent, low-grade spinal cord gliomas. Therefore, a retrospective study of temozolomide (TMZ) in adults with recurrent low-grade spinal cord gliomas with a primary objective of determining progression-free survival (PFS) was performed.<bold>Methods: </bold>Twenty-two patients (11 men and 11 women) aged 20 years to 55 years (median, 35 years) with recurrent spinal cord gliomas (World Health Organization grade 2 astrocytoma in 19 patients and oligoastrocytoma in 3 patients) were treated. All had previously been treated with surgery and involved-field radiotherapy. Thirteen patients underwent repeat surgery. All patients were chemotherapy-naive. TMZ was administered at a dose of 150-200 mg/m(2)/day for 5 consecutive days every 4 weeks (operationally defined as a single cycle). Neurologic and neuroradiographic evaluations were performed every 8 weeks.<bold>Results: </bold>All patients were evaluable for toxicity and response. A total of 266 cycles of TMZ (median, 14 cycles; range, 2 cycles-24 cycles) was administered. TMZ-related toxicity included constipation (9 patients, 1 with grade 3), lymphopenia (9 patients, 1 with grade 3), fatigue (7 patients, 1 with grade 3), neutropenia (6 patients, 2 with grade 3), and thrombocytopenia (6 patients, 2 with grade 3). Four (18%) patients demonstrated a partial radiographic response, 12 (55%) demonstrated stable disease, and 6 (27%) had progressive disease after 2 cycles of TMZ. Time to tumor progression ranged from 2 months to 28 months (median, 14.5 months). Survival ranged from 4 months to 39 months (median, 23 months). PFS at 6 months, 12 months, 18 months, and 24 months was 64%, 64%, 41%, and 27%, respectively.<bold>Conclusions: </bold>TMZ demonstrated modest efficacy with acceptable toxicity in this cohort of adult patients with recurrent low-grade spinal cord gliomas.
- Subjects
GLIOMA treatment; NERVOUS system tumors; SPINAL cord cancer; ANTINEOPLASTIC agents; CANCER chemotherapy; TUMOR treatment; CANCER relapse; COMPARATIVE studies; DRUG administration; GLIOMAS; RESEARCH methodology; MEDICAL cooperation; PROGNOSIS; RESEARCH; SPINAL cord tumors; EVALUATION research; RETROSPECTIVE studies; DACARBAZINE; THERAPEUTICS
- Publication
Cancer (0008543X), 2008, Vol 113, Issue 5, p1019
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.23677