Temozolomide for recurrent low‐grade spinal cord gliomas in adults

Chamberlain, Marc C.

doi:10.1002/cncr.23677

Cited by 61 publications

(28 citation statements)

References 33 publications

(65 reference statements)

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“…This resulted in a final study group of 18 studies published between 2003 and 2009, being selected for statistical pooling. In total 708 patients were included from 12 prospective observational [20][21][22][23][24][25][26][27][28][29][30][31] and 6 retrospective studies [32][33][34][35][36][37] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Using different schedules of Temozolomide to treat low grade gliomas: systematic review of their efficacy and toxicity

et al. 2011

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Low grade gliomas (LGG) contribute to 50% of all central nervous tumors in children and 15% of all gliomas in adults. Temozolomide (TMZ) is an oral alkylating agent with activity in high and LGG. Various regimens of TMZ are currently in use. We attempted to assess the impact of different TMZ regimens on the treatment of LGG. A systematic review of the literature identified all the studies published in Pubmed, EMBASE and Cochrane databases which met the inclusion criteria. The primary outcome measure was the impact of different TMZ regimens on the 12 month progression-free survival (PFS) rates of patients diagnosed with progressive LGG. Secondary outcome measures looked at the ability of the three regimens to elicit an objective response and the associated toxicity. Statistical pooling and calculation of weighted mean average of each proportion (WMAP) was conducted using a random-effects model. 18 studies (736 patients) were analyzed. PFS at 12 months revealed a WMAP of 0.61 (95% CI 0.44-0.78) for regimen A, 0.59 (0.28-0.89) for regimen B, and 0.91 (95% CI 0.83-0.99) for regimen C (Regimen A--200 mg/m(2)/day for 5 days, repeated every 4 weeks; B--75 mg/m(2)/day for 21 days repeated every 4 weeks; C--75 mg/m(2)/day for 7 weeks with 4 weeks of every 11 weeks). In terms of objective response, WMAP were 0.19 (95% 0.13-0.25), 0.27 (95% CI 0.15-0.39) and 0.21 (95% CI 0.10-0.32) for regimen A, B, C respectively. When analyzing hematological toxicity, WMAPs were 0.14 (95% 0.11-0.18), 0.35 (0.14-0.56) and 0.23 (95% CI 0.03-0.43). The bulk of evidence originates from the standard 5 day/month regimen A but with a lack of comparative studies. Analysis revealed significant heterogeneity. Although there is possibly an indication that metronomic regimens of TMZ result in better PFS and response rate when compared to the conventional standard 5 day regimen, insufficient available data and study heterogeneity preclude any safe conclusions. Well designed randomized controlled clinical trials are needed to establish the efficacy of metronomic regimens of TMZ in LGGs.

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Section: Resultsmentioning

confidence: 99%

Using different schedules of Temozolomide to treat low grade gliomas: systematic review of their efficacy and toxicity

et al. 2011

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“…There is an extremely limited number of retrospective series and single case reports, suggesting that regimens used in the treatment of cerebral gliomas may be beneficial in spinal cord gliomas [34][35][36][37][38]. To the best of our knowledge, this is the largest study reporting the results of simultaneous chemoradiation in spinal cord gliomas.…”

Section: Compliance With Ethical Guidelinesmentioning

confidence: 91%

Radiotherapy of spinal cord gliomas

Corradini¹,

Hadi²,

Hankel

et al. 2015

Strahlenther Onkol

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Despite the aggressive treatment in the present study, the prognosis for spinal cord gliomas was still poor, with a median overall survival of 6 months. To the best of our knowledge, this is the largest study reporting the results of simultaneous chemoradiation in spinal cord gliomas. A combined chemoradiation treatment seems feasible and can be considered as a new treatment option in the management of spinal cord gliomas.

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“…Studies for chemotherapy for astrocytomas are limited and further, larger studies are warranted. One study showed that temozolomide treatment led to 27% progression-free survival at 2 years with a median survival of 23 months [13]. However, toxicity complications included constipation, lymphopenia, fatigue, neutropenia, and thrombocytopenia [13].…”

Section: Treatment and Outcomesmentioning

confidence: 99%