429P - Phase II trial of temozolomide and reirradiation using conformal 3D-radiotherapy in recurrent brain gliomas

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Central Nervous System Malignancies
Surgery and/or Radiotherapy of Cancer
Presenter Mohammed Osman
Citation Annals of Oncology (2014) 25 (suppl_4): iv137-iv145. 10.1093/annonc/mdu330
Authors M.A.M. Osman, H.A. Mohamed
  • Oncology, Ain Shams University, 11321 - Cairo/EG

Abstract

Aim

This phase II trial was designed to assess the response rate, survival benefits and toxicity profile of temozolomide, and brain reirradiation using conformal radiotherapy for treatment of recurrent brain glioma. The primary end point of the study was response. The secondary end points included overall survival (OS), progression-free survival (PFS), toxicity, and the quality of life (QOL).

Methods

Setting: Oncology Unit, Ain Shams University Hospital, Cairo, Egypt.

Patients: Thirty patients had been enrolled in the study between February 2006 and June 2009. Patients had to show unequivocal evidence of tumour recurrence on gadolinium-enhanced magnetic resonance imaging after failing conventional radiotherapy with or without temozolomide and surgery for initial disease. Histology included recurrent anaplastic astrocytoma, glioblastoma multiforme, low grade glioma, and ependymoma.

Interventions: Patients were treated by temozolomide at a dose of 200 mg/m²/day for chemonaïve patients, and at a dose of 150 mg/m²/day to previously treated patients, for 4-5 cycles. Then, patients underwent reirradiation by conformal radiotherapy at a dose of 30-40 Gy. by conventional fractionation.

Results

All the 30 patients were treated with temozolomide and reirradiation. Two patients achieved complete remission (CR), 5 achieved partial remission (PR), with an overall objective response rate of 23.3%, and further 10 patients had stable3 disease (SD), with a SD rate of 33.3%. The mean progression free survival (PFS) was 10.1 months, and the mean overall survival (OS) was 11.4 months. Additionally, treatment significantly improved quality of life (QOL).Treatment was tolerated well with mild grade 1, 2 nausea/vomiting in 40% of cycles, and mild grade 1, 2 hematological toxicities (neutropenia/thrombocytoprnia) in 9.6% of cycles.

Conclusions

Temozolomide and conformal radiotherapy had an anti-tumor activity in recurrent malignant glioma, and represented a good treatment hope for patients with recurrent brain glioma.

Disclosure

All authors have declared no conflicts of interest.