Effects of palliative treatment with temozolomide in patients with high-grade gliomas

Background and purpose: T lie aim of the study was to assess the results of treatment with temozolomide in patients with high-grade gliomas who no longer benefit from surgical treatment and radiotherapy. Material and methods: The retrospective analysis included 5 1 patients treated between 200 1 and 2007 in the Centre of Oncology in Krakow. Glioblastoma multiforme was histologically diagnosed in 24 (47%) patients; anaplastic astrocytomas and other grade III gliomas (according to WHO classification) were diagnosed in 27 (53%) patients. Patients received 1-11 cycles of treatment with temozolomide - 210 cycles were given in total. Forty-five patients were eligible for efficacy assessment because 6 patients received only one chemotherapy cycle (due to rapid progression of the glioma). Results: According to the radiological assessment, 6 patients (13%) had an objective response and a further 16 patients (36%) had stabilization of the glioma. Subjective improvement was noted in 26 patients (58%), and neurological improvement was observed in 14 patients (31%). The median survival in the whole group was 41 weeks (40 weeks in patients with glioblastoma multiforme and 54 weeks in patients with anaplastic gliomas). One-year overall survival in the above-mentioned groups was 40.7%, 22%, and 50%, respectively. Two-year overall survival was 16%, 8%, and 20.9%, respectively Adverse events were observed during 73 (3596) cycles of treatment and prompted a dose reduction in 12 (24.5%) patients. The most frequent adverse events were: thrombocytopenia, leukopenia, nausea and vomiting. Adverse events did not lead to treatment withdrawal in any patient. Conclusions: Objective benefit from the temozolomide treatment (stabilization or objective remission) was observed in 49% of patients irrespective of histological diagnosis. Tolerability of treatment with temozolomide in patients with high-grade gliomas is good.