Toxicity Profile of Temozolomide in the Treatment of 300 Malignant Glioma Patients in Korea

et al. 2015

J Korean Med Sci

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This study was performed to validate the effectiveness and safety of concurrent chemoradiotherapy and adjuvant therapy with temozolomide for newly diagnosed glioblastoma multiforme as a standard treatment protocol. Between 2004 and 2011, patients newly diagnosed with glioblastoma who were treated with temozolomide during concurrent chemoradiotherapy and adjuvant chemotherapy were included from a single institution and analyzed retrospectively. The primary endpoint was overall survival, and the secondary endpoints were progression-free survival, response, and safety. A total of 71 patients were enrolled in this study. The response rate was 41% (29/71), and the tumor control rate was 80% (57/71). In the 67 patients who completed the concurrent chemoradiotherapy with temozolomide, the median overall survival was 19 months and the 1- and 2-yr overall survival rates were 78.3% and 41.7%, respectively. The median progression free survival was 9 months, and the 1- and 2-yr progression free survival rates were 33.8% and 14.3%, respectively. The mean duration of survival after progression of disease in salvage treatment group was 11.9 (1.3-53.2) months. Concurrent chemoradiotherapy with temozolomide resulted in grade 3 or 4 hematologic toxic effects in 2.8% of the patients. The current protocol of temozolomide during and after radiation therapy is both effective and safe and is still appropriate as the standard protocol for treatment of glioblastoma. An active salvage treatment might be required for a better prognosis.

Section: Discussionsupporting

confidence: 94%

Validation of the Effectiveness and Safety of Temozolomide during and after Radiotherapy for Newly Diagnosed Glioblastomas: 10-year Experience of a Single Institution

Joo

et al. 2015

J Korean Med Sci

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“…However, itchy skin, hair loss, and weakness of legs were worsened. This might be the effects of hair shaving and postoperative chemotherapy [15]. …”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life in Brain Tumor Patients Treated with Surgery: Preliminary Result of a Single Institution

Joo

et al. 2016

Brain Tumor Res Treat

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BackgroundAlongside the extent of removal and patients’ survival in the management of brain tumors, health-related quality of life (HRQOL) has become an important consideration. The purpose of this study is to evaluate the change of HRQOL in brain tumor patients before and after surgery and to assess the associated factors that contribute to the change of HRQOL.MethodsA total of 258 patients who underwent surgical treatment were enrolled in this study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC QLQ-C30) and the 20-item EORTC QLQ-Brain Neoplasm (QLQ-BN20) were used to assess HRQOL. Patients were asked to fill out the questionnaires before and 3-6 months after surgery.ResultsGlobal QOL (p<0.001) and emotional function (p<0.018) were significantly improved after surgery. Physical function (p=0.015) was significantly aggravated. Among the symptoms, headache, pain and nausea and vomiting were significantly decreased (p<0.01, p=0.041, p<0.001, respectively), while dyspnea, communication deficit and weakness of the legs were increased (p=0.005, p=0.040, and p=0.014, respectively). Preoperative neurologic deficit (p=0.019) and tumor diameter (p=0.016) were significantly related to the patients who showed aggravation of global QOL after brain tumor surgery. In the aggravated global QOL group, common complaints and concerns included role function, appetite loss, financial difficulty and future uncertainty.ConclusionIn brain tumor patients, HRQOL has improved after surgery. Role function, appetite loss, financial difficulty and future uncertainty were important factors for HRQOL in brain tumor patients treated with surgery. Although there is National Health Insurance and Medical Aid program in Korea, financial difficulty and future uncertainty are much more important in influencing QOL than previously thought. The results of this short-term follow up preliminary study suggest that several factors were related to HRQOL, Further research is needed to evaluate the long term change of HRQOL and enhance the global QOL by analyze related factors.

Molecular Nutrition Food Res

“…Temozolomide (TMZ) is an alkylating chemotherapeutic agent that is currently used for the treatment of glioblastoma . The therapeutic benefit of TMZ depends on its ability to alkylate/methylate nucleic acids.…”

Section: Honokiol As a Chemo‐ And Radio‐ Sensitizermentioning

confidence: 99%

Honokiol targets mitochondria to halt cancer progression and metastasis

Pan

Lee

Wang

et al. 2016

Cancer continues to be the leading cause of death worldwide. Plants have a long history of use in the treatment of cancer. Honokiol (HNK) is an important bioactive compound found in the bark of Magnolia tree, and has been shown to inhibit cancer growth and metastasis in many cell types in vitro and in animal models. Resistance to chemotherapy and radiotherapy is the major obstacle for cure of cancer. Combination of HNK with many traditional chemotherapeutic drugs as well as radiation sensitizes cancer cells to apoptotic death, suggesting that HNK not only directly inhibits primary cancers and metastasis, but also has potential to overcome drug resistance. Ultimately, this may mean that HNK could be combined with traditional chemotherapies administered at lower doses to significantly reduce toxicity, meanwhile enhance efficacy. As a natural compound, HNK is composed of polyphenols and has been described in many studies targeting multiple key cell signaling molecules. Mitochondria are the main hub for cellular energy production and play an important role in cell survival, and are the key target identified for HNK to mediate cancer cell death, survival, and metastasis. In this review, we have summarized different aspects of HNK's anti-cancer effects from recent accumulated literature, as well as the underlying molecular mechanisms. This review is primarily focused on the effects of HNK on epidermal growth factor receptor (EGFR) and signal transduction and activator of transcription 3 (STAT3) signaling, as well as the broader regulation of mitochondrial function and cancer cell metabolism.