Hong Kong Med J 2005;11:452-6 | Number 6, December 2005
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.
Key words: Astrocytoma; Brain neoplasms; Disease-free survival; Glioblastoma; Neoplasm recurrence
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