Efficacy and Toxicity of Postoperative Temozolomide Radiochemotherapy in Malignant Glioma

摘要: To evaluate the feasibility, safety and efficacy of daily temozolomide concurrent with postoperative radiotherapy in malignant glioma. From 11/1999 to 03/2003, n = 81 patients aged 15–72 years (median 52 years, Karnofsky score 80–100% 83%) suffering from primary glioblastoma (n 47), anaplastic astrocytoma 6), oligodendroglioma 16), recurrent glioma 12) were treated. Patients gliomas received a combination (60 Gy/1.8- 2.0-Gy fractions) oral (75 mg/m2) at all irradiation days (30–33 doses), while tumors treated 45–60 Gy temozolomide. Initially, 6/81 had doses 50 mg/m2. In total, 70/81 (86%) completed both radio- chemotherapy. Grade 1 nausea/vomiting was seen 28%, grade 2 11%, 3 1%. Antiemetics applied 41%. Hematologic toxicities observed as follows: leukopenia 3/4 1%, lymphopenia 46%, thrombopenia Two under dexamethasone suffered herpes encephalitis after one 16 mg/m2). Median survival 15 months for glioblastoma. patients, 4-year rate 78% observed. Postoperative radiochemotherapy 30–33 is safe The combined schedule effective may prolong Effort should be taken minimize corticosteroid doses, since steroids lead immunosuppression.