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KMID : 1001920130540060489
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Journal of Korean Neurosurgical Society
2013 Volume.54 No. 6 p.489 ~ p.495
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Temozolomide Salvage Chemotherapy for Recurrent Anaplastic Oligodendroglioma and Oligo-Astrocytoma
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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 Eal-Maan
Kim Hae-Yu
Ko Young-Cho
Yun Hwan-Jung
Youn Ji-Hye
Kim Ju-Young
Lee Byeong-Il
Lee Seung-Hoon
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Abstract
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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.
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KEYWORD
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Anaplastic oligodendroglioma, Anaplastic oligoastrocytoma, Chemotherapy, Recurrence, Temozolomide
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