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 language | English |
|---|---|
| Pages (from-to) | 535-541 |
| Number of pages | 7 |
| Journal | Child's Nervous System |
| Volume | 25 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 1 2009 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - Efficacy of temozolomide for recurrent embryonal brain tumors in children
AU - Wang, Chung H.
AU - Hsu, Ting Rong
AU - Wong, Tai-Tong
AU - Chang, Kai Ping
PY - 2009/5/1
Y1 - 2009/5/1
N2 - 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.
AB - 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.
KW - Children
KW - Embryonal tumor
KW - Medulloblastoma
KW - Temozolomide
UR - http://www.scopus.com/inward/record.url?scp=64249139559&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=64249139559&partnerID=8YFLogxK
U2 - 10.1007/s00381-008-0781-7
DO - 10.1007/s00381-008-0781-7
M3 - Article
C2 - 19107490
AN - SCOPUS:64249139559
VL - 25
SP - 535
EP - 541
JO - Child's Nervous System
JF - Child's Nervous System
SN - 0256-7040
IS - 5
ER -