Temozolomide Salvage Chemotherapy for Recurrent Anaplastic Oligodendroglioma and Oligo-Astrocytoma
Authors
Gwak Ho-Shin ; Yee Gi Taek ; Park Chul-Kee ; Kim Jin Wook ; Hong Yong-Kil ; Kang Seok-Gu ; Kim Jeong Hoon ; Seol Ho Jun ; Jung Tae-Young ; Chang Jong Hee ; Yoo Heon ; Hwang Jeong-Hyun ; Kim Se-Hyuk ; Park Bong Jin ; Hwang Sun-Chul ; Kim Min Su ; Kim Seon-Hwan ; Kim Eun-Young ; Kim Ealmaan ; Kim Hae Yu ; Ko Young-Cho ; Yun Hwan Jung ; Youn Ji Hye ; Kim Juyoung ; Lee Byeongil ; Lee Seung Hoon
Citation
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, Vol.54(6) : 489-495, 2013
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 (≥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.