Abstract
Background:
The aim of this study was to evaluate the effectiveness and possible toxicity of the combination of temozolomide (TMZ) with whole-brain irradiation (WBI) in the treatment of brain metastases from solid tumors.
Patients and methods:
33 patients with brain metastases were included in the study and treated with TMZ 60 mg/m2/day (days 1-16) concomitantly with WBI (36 Gy/12 fractions given in 16 days). One month after the end of radiotherapy, 6 cycles of TMZ were administered as adjuvant treatment (200 mg/m2/day for 5 consecutive days every 28 days).
Results:
Responses were assessed using computed tomography at the end of the 3rd and 6th cycle of chemotherapy. The objective response rate was 54.5% and 57.6% after the 3rd and the 6th cycle, respectively. The median overall survival was 12 months. In patients with metastases from lung cancer the objective response rate was 11/14 (78.6%) after both the 3rd and the 6th cycle of treatment. The most common side effects were anemia (24.2%), thrombocytopenia (18.2%), as well as nausea and vomiting (18.2%). The high incidence of hepatotoxicity (45.5%) might be related to concomitantly administered antiepileptic drugs and not to TMZ.
Conclusion:
WBI combined with TMZ as concomitant and adjuvant treatment is effective in treating brain metastases, with acceptable mild side effects.
MeSH terms
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Aged
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Aged, 80 and over
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Antineoplastic Agents, Alkylating / adverse effects
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Antineoplastic Agents, Alkylating / therapeutic use*
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Brain Neoplasms / drug therapy
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Brain Neoplasms / mortality
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Brain Neoplasms / radiotherapy
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Brain Neoplasms / secondary*
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Breast Neoplasms / drug therapy
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Breast Neoplasms / mortality
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Breast Neoplasms / radiotherapy
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Carcinoma, Non-Small-Cell Lung / drug therapy
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Carcinoma, Non-Small-Cell Lung / mortality
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Carcinoma, Non-Small-Cell Lung / radiotherapy
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Carcinoma, Non-Small-Cell Lung / secondary
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Carcinoma, Small Cell / drug therapy
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Carcinoma, Small Cell / mortality
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Carcinoma, Small Cell / radiotherapy
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Carcinoma, Small Cell / secondary
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Chemotherapy, Adjuvant
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Clinical Trials, Phase II as Topic
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Combined Modality Therapy
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Cranial Irradiation*
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Dacarbazine / adverse effects
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Dacarbazine / analogs & derivatives*
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Dacarbazine / therapeutic use
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Female
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Humans
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Lung Neoplasms / drug therapy
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Lung Neoplasms / mortality
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Lung Neoplasms / radiotherapy
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Male
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Melanoma / drug therapy
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Melanoma / mortality
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Melanoma / radiotherapy
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Melanoma / secondary
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Middle Aged
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Mouth Neoplasms / drug therapy
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Mouth Neoplasms / mortality
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Mouth Neoplasms / radiotherapy
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Neoplasms, Unknown Primary / drug therapy
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Neoplasms, Unknown Primary / mortality
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Neoplasms, Unknown Primary / radiotherapy
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Palliative Care
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Rectal Neoplasms / drug therapy
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Rectal Neoplasms / mortality
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Rectal Neoplasms / radiotherapy
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Research Design
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Temozolomide
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Treatment Outcome
Substances
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Antineoplastic Agents, Alkylating
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Dacarbazine
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Temozolomide