The effect of combining temozolomide treatment with bevacizumab for intramedullary spinal cord glioma

Abstract

Study Design: The current standard therapies for the management of intramedullary malignant gliomas include surgery, chemotherapy, and radiotherapy. Concurrent or adjuvant temozolomide (TMZ) has been considered an emerging new treatment for intramedullary malignant gliomas. Although TMZ does not cure spinal cord tumor patients, it significantly improves patient survival and quality of life.Objective: In this study, we hypothesized that treatment with bevacizumab accelerates the therapeutic effect of TMZ on intramedullary gliomas in an animal model.Methods: C6 glioma cells were injected into the T5 level of the spinal cord, and TMZ and bevacizumab were administered 5 days after C6 inoculation. Tumor size was analyzed using histology and magnetic resonance imaging (MRI) at 13 days after tumor inoculation.Results: Histological analyses and MRI findings showed that combined treatment with TMZ and bevacizumab reduced tumor mass. Neurologic outcomes demonstrated that combined therapy improved hind limb function more than TMZ alone or control group.Conclusion: This study shows that bevacizumab could be useful in combination with TMZ to increase the therapeutic benefits of TMZ for intramedullary spinal cord tumors.