Temozolomide
chemotherapy for progressive low-grade glioma: clinical benefits and
radiological response
A. Pace1, A. Vidiri2,
E. Galiè1, M. Carosi3,
S. Telera1, A. M. Cianciulli4,
P. Canalini3, D. Giannarelli5,
B. Jandolo1 and C. M. Carapella1
1Department of Neuroscience, 2 Department of Diagnostic Imaging, 3
Service of Anatomo-Pathology, 4 Service of Clinical Pathology and 5
Statistical Unit, Regina Elena National Cancer Institute, Rome, Italy.
Received 19 June 2003; revised 30 September 2003; accepted 2 October 2003.
Background. The
optimal treatment for low-grade glioma (LGG) is still controversial.
Recent data indicate a potential influence of chemotherapy on the
natural evolution of these tumors, allowing for the deferral of more
aggressive therapies.
Patients and
Methods.
Forty-three patients affected
with LGG (29 astrocytoma, four oligodendroglioma and 10 mixed
oligo-astrocytoma) were treated with temozolomide (TMZ) at the time
of documented clinical and radiological progression.
McDonald’s response criteria were utilized to evaluate TMZ
activity.
Thirty patients (69.7%) had previously received radiotherapy; 16
(37.2%) had received prior chemotherapy.
Clinical benefit was evaluated measuring seizure control, reduction
in steroid dose and modification of Karnofsky performance status and
Barthel index.
Quality of life was assessed with the QLQ-C30 questionnaire.
Results. We
observed a complete response in four patients, 16 partial responses,
17 stable disease (with four minor response) and six progressive
disease.
Median duration of response was 10 months [95% confidence interval
(CI) 8–12], with a 76% rate of progression free survival (PFS) at 6
months, and a 39% rate of PFS at 12 months.
A relevant clinical benefit was observed particularly in patients
presenting epilepsy.
Conclusions.
The high response rate of 47%
(95% CI 31% to 61%) confirms that TMZ chemotherapy is a valid option
in the treatment of progressive LGG.
The present preliminary results seem interesting and warrant further
evaluation of TMZ clinical activity in a larger series of progressive
LGG.
Key words: chemotherapy,
epilepsy, low-grade glioma
© 2003
European
Society for Medical Oncology
Source: http://annonc.oupjournals.org/cgi/content/abstract/14/12/1722?etoc
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