Temozolomide as an alternative to irradiation for elderly patients with newly diagnosed malignant gliomas

Michael Glantz, Marc Chamberlain, Qin Liu, N. Scott Litofsky, Lawrence D. Recht

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125 Scopus citations

Abstract

BACKGROUND. The optimal treatment for elderly patients (defined as patients 70 years of age or older) with malignant gliomas (MG) remains controversial. Some physicians advocate withholding therapy following diagnosis based on the observation that elderly patients do not tolerate adjuvant radiotherapy. The availability of temozolomide (TMZ), a new alkylating agent with antiglioma efficacy, offers another potential therapeutic option for these patients. The drug can be administered orally at home with minimal morbidity. METHODS. The authors retrospectively reviewed a cohort of 86 consecutive elderly MG patients from three institutions, 32 of whom received monthly TMZ in lieu of radiation. RESULTS. Initial Karnofsky performance score was the only predictor of survival in this cohort. No difference in survival was noted between these two groups. Toxicity was minimal in the chemotherapy-treated group and a higher percentage of patients receiving chemotherapy died at home. CONCLUSIONS. The authors concluded that TMZ is as effective as irradiation as a treatment of elderly patients with MG. It is an alternative and, perhaps, a superior therapeutic option to irradiation, based on its ease of administration and low morbidity.

Original languageEnglish (US)
Pages (from-to)2262-2266
Number of pages5
JournalCancer
Volume97
Issue number9
DOIs
StatePublished - May 1 2003

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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