Temozolomide Salvage Chemotherapy for Recurrent Anaplastic Oligodendroglioma and Oligo-Astrocytoma.
10.3340/jkns.2013.54.6.489
- Author:
Ho Shin GWAK
1
;
Gi Taek YEE
;
Chul Kee PARK
;
Jin Wook KIM
;
Yong Kil HONG
;
Seok Gu KANG
;
Jeong Hoon KIM
;
Ho Jun SEOL
;
Tae Young JUNG
;
Jong Hee CHANG
;
Heon YOO
;
Jeong Hyun HWANG
;
Se Hyuk KIM
;
Bong Jin PARK
;
Sun Chul HWANG
;
Min Su KIM
;
Seon Hwan KIM
;
Eun Young KIM
;
Ealmaan KIM
;
Hae Yu KIM
;
Young Cho KO
;
Hwan Jung YUN
;
Ji Hye YOUN
;
Juyoung KIM
;
Byeongil LEE
;
Seung Hoon LEE
Author Information
1. Registration Group, Korean Society for Neuro-Oncology, Korea. nslsh@ncc.re.kr
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Anaplastic oligodendroglioma;
Anaplastic oligoastrocytoma;
Chemotherapy;
Recurrence;
Temozolomide
- MeSH:
Disease-Free Survival;
Drug Therapy*;
Follow-Up Studies;
Humans;
Lomustine;
Oligodendroglioma*;
Procarbazine;
Recurrence;
Retrospective Studies;
Salvage Therapy;
Vincristine
- From:Journal of Korean Neurosurgical Society
2013;54(6):489-495
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the efficacy of temozolomide (TMZ) chemotherapy for recurrent anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA). METHODS: A multi-center retrospective trial enrolled seventy-two patients with histologically proven AO/AOA who underwent TMZ chemotherapy for their recurrent tumors from 2006 to 2010. TMZ was administered orally (150 to 200 mg/m2/day) for 5 days per 28 days until unacceptable toxicity occurred or tumor progression was observed. RESULTS: TMZ chemotherapy cycles administered was median 5.3 (range, 1-41). The objective response rate was 24% including 8 cases (11%) of complete response and another 23 patients (32%) were remained as stable disease. Severe side effects (> or =grade 3) occurred only in 9 patients (13%). Progression-free survival (PFS) of all patients was a median 8.0 months (95% confidence interval, 6.0-10.0). The time to recurrence of a year or after was a favorable prognostic factor for PFS (p<0.05). Overall survival (OS) was apparently differed by the patient's histology, as AOA patients survived a median OS of 18.0 months while AO patients did not reach median OS at median follow-up of 11.5 months (range 2.7-65 months). Good performance status of Eastern Cooperative Oncology Group 0 and 1 showed prolonged OS (p<0.01). CONCLUSION: For recurrent AO/AOA after surgery followed by radiation therapy, TMZ could be recommended as a salvage therapy at the estimated efficacy equal to procarbazine, lomustine, and vincristine (PCV) chemotherapy at first relapse. For patients previously treated with PCV, TMZ is a favorable therapeutic option as 2nd line salvage chemotherapy with an acceptable toxicity rate.
