Continuous Low-Dose Temozolomide Chemotherapy and Microvessel Density in Recurrent Glioblastoma
| Autor: | Seung Ho Yang, Yong Kil Hong, Jeana Kim, Jong-Yun Woo, Youn Soo Lee, Su Youn Lee |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Oncology
medicine.medical_specialty medicine.medical_treatment Microvessel density Internal medicine medicine Temozolomide Chemotherapy Clinical Article business.industry General Neuroscience Recurrent glioblastoma Metronomic chemotherapy medicine.disease Metronomic Chemotherapy Surgery Regimen Tumor progression Neurology (clinical) business Glioblastoma medicine.drug |
| Zdroj: | Journal of Korean Neurosurgical Society |
| ISSN: | 2005-3711 |
| Popis: | Objective : The purpose of this study was to evaluate the clinical efficacy of continuous low-dose temozolomide (TMZ) chemotherapy for recurrent and TMZ-refractory glioblastoma multiforme (GBM) and to study the relationship between its efficacy and microvessel density within the tumor. Methods : Thirty patients who had recurrent GBM following Stupp's regimen received TMZ daily at 50 mg/m 2 /day until tumor progression between 2007 and 2013. The median duration of continuous low-dose TMZ administration was 8 weeks (range, 2-64). Results : The median progression-free survival (PFS) of continuous low-dose TMZ therapy was 2 months (range, 0.5-16). At 6 months, PFS was 20%. The median overall survival (OS) from the start of this therapy to death was 6 months (95% CI : 5.1-6.9). Microvessel density of recurrent tu- mor tissues obtained by reoperation of 17 patients was 22.7±24.1/mm 2 (mean±standard deviation), and this was lower than that of the initial tu- mor (61.4±32.7/mm 2 ) (p-value=0.001). It suggests that standard TMZ-chemoradiotherapy reduces the microvessel density within GBM and that recurrences develop in tumor cells with low metabolic burden. The efficacy of continuous low-dose TMZ could not be expected in recurrent GBM cells in poor angiogenic environments. Conclusion : The efficacy of continuous low-dose TMZ chemotherapy is marginal. This study suggests the need to develop further treatment strate - gies for recurrent and TMZ-refractory GBM. |
| Databáze: | OpenAIRE |
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