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Erschienen in: Wiener klinische Wochenschrift 15-16/2013

01.08.2013 | original article

Temozolomide added to whole brain radiotherapy in patients with multiple brain metastases of non-small-cell lung cancer: a multicentric Austrian phase II study

verfasst von: Marco Ronald Hassler, MD, Wolfgang Pfeifer, MD, Thomas Hendrik Knocke-Abulesz, MD, Klaus Geissler, MD, Gabriele Altorjai, MD, Karin Dieckmann, MD, Prof. Christine Marosi, MD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 15-16/2013

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Summary

Background

This multicentric randomized phase II study investigated the feasibility and toxicity of temozolomide (TMZ) added to whole brain radiotherapy (WBRT) followed by adjuvant TMZ in patients with multiple brain metastases of non-small-cell lung cancer (NSCLC).

Methods

Patients with multiple brain metastases from NSCLC aged ≥ 18 years, classified according to recursive partitioning analysis class I or II and with adequate organ functions were eligible. Treatment consisted of WBRT + TMZ 75 mg/m2 for 2 weeks followed at day 28 by TMZ 100 mg/m2/day 2 weeks on/2 weeks off for up to 6 months (radiochemotherapy, RCT) or WBRT alone (radiotherapy, RT).

Results

The study enrolled only 35 patients (22 patients in RCT and 13 in RT) and had to be closed prematurely due to poor accrual. The toxicity was mainly due to TMZ with WHO grade 3 and 4 thrombocytopenia in 3/22 versus 0/13, leucocytopenia in 1/22 versus 0/13 and lymphocytopenia in 7/22 versus 12/13 patients in RCT and RT respectively. Thirteen patients in RCT and six in RT progressed systemically and dropped out before first restaging of the response in brain. Median time to progression (TTP) was 2.4 months (95 % CI: 2–2.6 months) and 2.0 months (95 % CI: 0.5–3.5 months), median overall survival (OAS) was 3 months (95 % CI: 1.7–3.1 months) and 6.3.months (95 % CI: 0.2–7.6 months) in RCT and RT, respectively.

Conclusions

Like other studies before on patients with brain metastases, insufficient number of recruited patients does not allow conclusions on efficacy and toxicity as the study closed prematurely.
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Metadaten
Titel
Temozolomide added to whole brain radiotherapy in patients with multiple brain metastases of non-small-cell lung cancer: a multicentric Austrian phase II study
verfasst von
Marco Ronald Hassler, MD
Wolfgang Pfeifer, MD
Thomas Hendrik Knocke-Abulesz, MD
Klaus Geissler, MD
Gabriele Altorjai, MD
Karin Dieckmann, MD
Prof. Christine Marosi, MD
Publikationsdatum
01.08.2013
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 15-16/2013
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-013-0402-7

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