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Temozolomide in the treatment of recurrent malignant glioma in Chinese patients
DTM Chan, WS Poon, YL Chan, HK Ng
Division of Neurosurgery, Department of Surgery, The Chinese University
of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
OBJECTIVE. To determine the anti-tumour efficacy
and safety profile of temozolomide in local Chinese patients with
recurrent malignant glioma.
DESIGN. Open-label trial.
SETTING. University teaching hospital, Hong Kong.
PATIENTS. Twenty-two patients had been enrolled
in the study since 2001. Patients had to show unequivocal evidence
of tumour recurrence or progression on gadolinium-enhanced magnetic
resonance imaging after failing conventional radiotherapy and surgery
for initial disease. Histology reviewed by a neuropathologist was
required to show anaplastic glioma (anaplastic astrocytoma, anaplastic
oligodendroglioma, or mixed anaplastic oligoastrocytoma) or glioblastoma
multiforme.
INTERVENTIONS. Patients were treated with temozolomide
(200 mg/m2 per day for the first 5 days of a 28-day cycle
for four cycles) and monitored clinically every month and radiologically
(gadolinium magnetic resonance imaging) at 6 months.
MAIN OUTCOME MEASURES. Six-month progression-free
survival and objective response rate.
RESULTS. Twenty-two patients with recurrent malignant
glioma were recruited between January 2001 and July 2004. Progression-free
survival at 6 months was 54.5%. The mean progression-free survival
for all patients was 7.2 months. The objective response rate, determined
by gadolinium magnetic resonance imaging, was 9% for patients demonstrating
a complete or partial response and a further 45% for patients demonstrating
stable disease. Temozolomide was well tolerated orally with minimal
adverse events.
CONCLUSION. Preliminary results showed that temozolomide
had an acceptable safety profile and anti-tumour activity in recurrent
malignant glioma in local Chinese population. The results were comparable
with those of western studies.
Hong Kong Med J 2005;11:452-6
Key words: Astrocytoma; Brain neoplasms; Disease-free survival; Glioblastoma; Neoplasm recurrence
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