Up-front temozolomide in elderly patients with anaplastic oligodendroglioma and oligoastrocytoma.

Abstract:

:Optimal treatment of anaplastic oligodendroglial tumors (AOT) in elderly patients is debatable. We report a retrospective study of 44 consecutive patients aged 70 years or older [median age: 74 years; median Karnofsky performance status (KPS): 70] treated with up-front chemotherapy using temozolomide (TMZ) at conventional doses until tumor progression. O(6)-methylguanine-DNA methyltransferase promoter (MGMTP) methylation was assessed in 38 patients. Of the 41 evaluable patients, partial response (PR) was seen in 13 (32%) patients, 17 (41%) patients achieved stable disease, while the disease progressed in 11 (27%) patients. Median progression-free survival (PFS) and overall survival (OS) were 6.9 and 12.4 months, respectively. Hematotoxicity grades 3-4 occurred in nine patients (20%). MGMTP was methylated in 50% of patients and was associated with both longer PFS (8.7 versus 5.7 months, P = 0.01) and longer OS (16.1 versus 12.4 months, P = 0.05). The rate of responders to chemotherapy was similar in MGMTP-methylated (38%) and in MGMTP-unmethylated patients (31%), but duration of response was significantly longer in responders with methylated MGMTP than in responders with unmethylated MGMTP (16.1 versus 9.6 months, P = 0.0004). This study demonstrates that a substantial number of elderly patients with AOT can achieve prolonged survival with up-front chemotherapy using TMZ. Further investigation is needed to determine whether this treatment is preferable to initial radiation therapy.

journal_name

J Neurooncol

authors

Ducray F,del Rio MS,Carpentier C,Psimaras D,Idbaih A,Dehais C,Kaloshi G,Mokhtari K,Taillibert S,Laigle-Donadey F,Omuro A,Sanson M,Delattre JY,Hoang-Xuan K

doi

10.1007/s11060-010-0264-z

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

457-62

issue

3

eissn

0167-594X

issn

1573-7373

journal_volume

101

pub_type

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