Efficacy of temozolomide for recurrent embryonal brain tumors in children

Chung H. Wang, Ting Rong Hsu, Tai-Tong Wong, Kai Ping Chang

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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 cisplastin-based chemotherapy. They all received once daily oral temozolomide (150 mg/m2/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.

Original languageEnglish
Pages (from-to)535-541
Number of pages7
JournalChild's Nervous System
Volume25
Issue number5
DOIs
Publication statusPublished - May 1 2009
Externally publishedYes

Fingerprint

temozolomide
Brain Neoplasms
Disease-Free Survival
Medulloblastoma
Bone Marrow
Magnetic Resonance Imaging
Primitive Neuroectodermal Tumors
Drug Therapy
Salvage Therapy
Central Nervous System Neoplasms
Neoplasms
Constipation

Keywords

  • Children
  • Embryonal tumor
  • Medulloblastoma
  • Temozolomide

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health

Cite this

Efficacy of temozolomide for recurrent embryonal brain tumors in children. / Wang, Chung H.; Hsu, Ting Rong; Wong, Tai-Tong; Chang, Kai Ping.

In: Child's Nervous System, Vol. 25, No. 5, 01.05.2009, p. 535-541.

Research output: Contribution to journalArticle

Wang, Chung H. ; Hsu, Ting Rong ; Wong, Tai-Tong ; Chang, Kai Ping. / Efficacy of temozolomide for recurrent embryonal brain tumors in children. In: Child's Nervous System. 2009 ; Vol. 25, No. 5. pp. 535-541.
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