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Journal of Neuro-Oncology

, Volume 101, Issue 2, pp 247–254 | Cite as

Temozolomide for malignant primary spinal cord glioma: an experience of six cases and a literature review

  • Wook-Ha Kim
  • Sang Hoon Yoon
  • Chae-Yong KimEmail author
  • Ki-jeong Kim
  • Min Mi Lee
  • Gheeyoung Choe
  • In-Ah Kim
  • Jee Hyun Kim
  • Yu Jung Kim
  • Hyun-Jib Kim
Clinical Study – Patient Study

Abstract

Malignant primary spinal cord gliomas (PSCGs) are rare, and the optimal treatment for these lesions remains controversial. We report herein treatment outcomes of six malignant PSCGs managed with temozolomide (TMZ)-based multidisciplinary treatment. TMZ was administered concomitantly with fractionated radiotherapy for two newly diagnosed primary spinal cord glioblastoma multiforme (GBM), followed by adjuvant chemotherapy with TMZ. For one anaplastic astrocytoma (AA) and one anaplastic ependymoma (AEPN), TMZ was given as adjuvant therapy at first recurrence. One malignantly transformed ependymoma (EPN) and one malignantly transformed diffuse astrocytoma (DA) were treated with TMZ after radiotherapy at second recurrence. Two patients with newly diagnosed GBM died, 12 and 16 months, respectively, after being treated with TMZ, during and after radiation therapy. One patient with AA and one with malignantly transformed EPN showed good response to salvage therapy with TMZ and had stable disease 21 and 20 months, respectively, after TMZ treatment. One patient with recurrent AEPN and one with malignantly transformed DA died from uncontrolled progression of the lesions despite TMZ chemotherapy. Three patients developed grade 1 or 2 neutropenia, anemia, and infection. Nonhematologic toxicities occurred in all patients; however, they were below grade 3 in severity. TMZ treatment may have a positive effect on control of malignant PSCGs and survival for some patients. Specifically, treatment with TMZ during and after radiation therapy might provide survival benefit to patients with primary spinal cord GBM. A multicenter cooperative investigation for a large-scale study on malignant PSCGs may be required.

Keywords

Spinal cord tumor Intramedullary Glioblastoma Anaplastic astrocytoma Anaplastic ependymoma Temozolomide 

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Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Wook-Ha Kim
    • 1
  • Sang Hoon Yoon
    • 1
  • Chae-Yong Kim
    • 1
    Email author
  • Ki-jeong Kim
    • 1
  • Min Mi Lee
    • 1
  • Gheeyoung Choe
    • 2
  • In-Ah Kim
    • 3
  • Jee Hyun Kim
    • 4
  • Yu Jung Kim
    • 4
  • Hyun-Jib Kim
    • 1
  1. 1.Department of NeurosurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeoulKorea
  2. 2.Department of PathologySeoul National University Bundang Hospital, Seoul National University College of MedicineSeoulKorea
  3. 3.Department of Radiation OncologySeoul National University Bundang Hospital, Seoul National University College of MedicineSeoulKorea
  4. 4.Department of Internal MedicineSeoul National University Bundang Hospital, Seoul National University College of MedicineSeoulKorea

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