Temozolomide for recurrent or progressive high-grade malignant glioma: Results of an Austrian multicenter observational study

Background: The use of chemotherapy in patients with malignant gliomas has remained a controversial issue even after the publication of favorable study data and a meta-analysis. The present study was initiated to support the use of chemotherapy in patients with relapsed high-grade gliomas (HGG). Patients and methods: Six Austrian centers recruited 43 patients with histologically confirmed HGG at first recurrence. Twelve chemotherapy-naive patients received oral temozolomide at a dose of 200 mg/m(2) once a day for five consecutive days and 26 patients a dose of 150 mg/m2 also for five days after various first-line chemotherapies. TMZ treatment was repeated every four weeks for a total of six cycles. Results: Twenty-one patients (52.5%) received at least six cycles of therapy. Two patients experienced complete remission and eight patients a partial response. Twenty patients survived at one year after enrolment in the study; eight patients survived beyond three years of follow-up. Hematological toxicities consisted of three thrombocytopenias G4 and 35 lymphocytopenias G3 and G4; these did not cause interstitial pneumonia or require inpatient treatment. Non-hematological toxicities were rare and without clinical relevance. Patients' quality of life was maintained during treatment. Conclusion: The study data confirm the feasibility and efficacy of chemotherapy with temozolomide in patients with relapsed/progressive HGG.