OBJECTIVE: The salvage therapy of recurrent embryonal brain tumors in children is disappointing. Temozolomide is a newly developed chemotherapeutic agent in central nervous system tumors. This study analyzed the efficacy of temozolomide on the treatment of recurrent embryonal brain tumors in children. MATERIALS AND METHODS: There were eight patients, including four with medulloblastoma (MB), three with atypical teratoid/rhabdoid tumor (AT/RT) and one with supratentorial primitive neuroectodermal tumor, whose tumors recurred after surgery and radiotherapy, with or without conventional intravenous cisplatin-based chemotherapy. They all received once daily oral temozolomide (150 mg/m(2)/day) for five consecutive days in a 28-day cycle. The responsiveness of the tumors to temozolomide was judged by magnetic resonance imaging (MRI) during regular follow-up. RESULTS: The median treatment cycles received by these eight patients were 17 (range from two to 59 cycles). The follow-up MRI showed no tumor progression in five patients at 6 months and four patients at 12 months. The median progression-free survival (PFS) of the eight patients was 15.7 months (range from 0 to 59 months). Complete response was achieved in one patient with MB accompanying with a long period of PFS for 26 months. Another patient with AT/RT showed partial response accompanying with a long period of PFS for 59 months. The observed adverse effects of temozolomide included nausea, vomiting, headache, constipation, mild marrow suppression, and decreased activity; none of them was severe enough to discontinue the treatment. No patient experienced moderate or severe marrow suppression in this series. CONCLUSION: In this preliminary study, oral temozolomide shows promising results on recurrent embryonal brain tumors in children. The adverse effects of temozolomide are mild and tolerable. When conventional chemotherapy fails and/or the adverse response is too severe to tolerate, temozolomide is a reasonable alternative. However, a further well-designed, controlled study and more long-term follow-up are needed to assess the exact role of temozolomide in children with embryonal tumors in brain.
OBJECTIVE: The salvage therapy of recurrent embryonal brain tumors in children is disappointing. Temozolomide is a newly developed chemotherapeutic agent in central nervous system tumors. This study analyzed the efficacy of temozolomide on the treatment of recurrent embryonal brain tumors in children. MATERIALS AND METHODS: There were eight patients, including four with medulloblastoma (MB), three with atypical teratoid/rhabdoid tumor (AT/RT) and one with supratentorial primitive neuroectodermal tumor, whose tumors recurred after surgery and radiotherapy, with or without conventional intravenous cisplatin-based chemotherapy. They all received once daily oral temozolomide (150 mg/m(2)/day) for five consecutive days in a 28-day cycle. The responsiveness of the tumors to temozolomide was judged by magnetic resonance imaging (MRI) during regular follow-up. RESULTS: The median treatment cycles received by these eight patients were 17 (range from two to 59 cycles). The follow-up MRI showed no tumor progression in five patients at 6 months and four patients at 12 months. The median progression-free survival (PFS) of the eight patients was 15.7 months (range from 0 to 59 months). Complete response was achieved in one patient with MB accompanying with a long period of PFS for 26 months. Another patient with AT/RT showed partial response accompanying with a long period of PFS for 59 months. The observed adverse effects of temozolomide included nausea, vomiting, headache, constipation, mild marrow suppression, and decreased activity; none of them was severe enough to discontinue the treatment. No patient experienced moderate or severe marrow suppression in this series. CONCLUSION: In this preliminary study, oral temozolomide shows promising results on recurrent embryonal brain tumors in children. The adverse effects of temozolomide are mild and tolerable. When conventional chemotherapy fails and/or the adverse response is too severe to tolerate, temozolomide is a reasonable alternative. However, a further well-designed, controlled study and more long-term follow-up are needed to assess the exact role of temozolomide in children with embryonal tumors in brain.
Authors: M Brada; K Hoang-Xuan; R Rampling; P Y Dietrich; L Y Dirix; D Macdonald; J J Heimans; B A Zonnenberg; J M Bravo-Marques; R Henriksson; R Stupp; N Yue; J Bruner; M Dugan; S Rao; S Zaknoen Journal: Ann Oncol Date: 2001-02 Impact factor: 32.976
Authors: H S Nicholson; M Krailo; M M Ames; N L Seibel; J M Reid; W Liu-Mares; L G Vezina; A G Ettinger; G H Reaman Journal: J Clin Oncol Date: 1998-09 Impact factor: 44.544
Authors: Paul Kleihues; David N Louis; Bernd W Scheithauer; Lucy B Rorke; Guido Reifenberger; Peter C Burger; Webster K Cavenee Journal: J Neuropathol Exp Neurol Date: 2002-03 Impact factor: 3.685
Authors: Tobey J MacDonald; Brian R Rood; Maria R Santi; Gilbert Vezina; Kimberly Bingaman; Philip H Cogen; Roger J Packer Journal: Oncologist Date: 2003
Authors: X Durando; Emilie Thivat; Olivier Gilliot; Bernard Irthum; Pierre Verrelle; Catherine Vincent; Jacques-Olivier Bay Journal: Cancer Invest Date: 2007-09 Impact factor: 2.176
Authors: H Stacy Nicholson; Cynthia S Kretschmar; Mark Krailo; Mark Bernstein; Richard Kadota; Daniel Fort; Henry Friedman; Michael B Harris; Nicole Tedeschi-Blok; Claire Mazewski; Judith Sato; Gregory H Reaman Journal: Cancer Date: 2007-10-01 Impact factor: 6.860
Authors: H S Friedman; M E Dolan; A E Pegg; S Marcelli; S Keir; J J Catino; D D Bigner; S C Schold Journal: Cancer Res Date: 1995-07-01 Impact factor: 12.701
Authors: C F Torres; S Rebsamen; J H Silber; L N Sutton; L T Bilaniuk; R A Zimmerman; J W Goldwein; P C Phillips; B J Lange Journal: N Engl J Med Date: 1994-03-31 Impact factor: 91.245
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Authors: R A Daniel; A L Rozanska; E A Mulligan; Y Drew; H D Thomas; D J Castelbuono; Z Hostomsky; E R Plummer; D A Tweddle; A V Boddy; S C Clifford; N J Curtin Journal: Br J Cancer Date: 2010-10-26 Impact factor: 7.640
Authors: Nicole A Shonka; Terri S Armstrong; Sujit S Prabhu; Amanda Childress; Shauna Choi; Lauren A Langford; Mark R Gilbert Journal: J Clin Med Res Date: 2011-04-04
Authors: Rebecca M Hill; Sabine L A Plasschaert; Beate Timmermann; Christelle Dufour; Kristian Aquilina; Shivaram Avula; Laura Donovan; Maarten Lequin; Torsten Pietsch; Ulrich Thomale; Stephan Tippelt; Pieter Wesseling; Stefan Rutkowski; Steven C Clifford; Stefan M Pfister; Simon Bailey; Gudrun Fleischhack Journal: Cancers (Basel) Date: 2021-12-28 Impact factor: 6.575
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