[Glioma therapy up-date].
The prognosis for patients with malignant brain tumors has always been poor and until recently chemotherapy had not shown to be very effective. Temozolomide is a novel second-generation alkylating agent that has shown efficacy for the treatment of high-grade gliomas. Temozolomide is well-tolerated by most patients and has favorable pharmacodynamic and pharmacokinetic properties. In patients with newly diagnosed glioblastoma multiforme, radiation therapy with concurrent and adjuvant temozolomide significantly improves overall survival compared to treatment with only radiation. The benefit of temozolomide is greatest in patients with tumors that have a methylated 06-methyl-guanine DNA methyl transferase gene promoter that results in decreased repair of temozolomide-induced DNA damage. This chapter will briefly review the diagnosis and treatment of patients with malignant brain tumors and then will focus on the role of temozolomide in glioma therapy.
de la Fuente
B Pilo
BP
Servicio de Neurología, Hospital Ramón y Cajal, Madrid, Spain.
Dalmau
J
J
Rosenfeld
M
M
D000925:Anticoagulants / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001254:Astrocytoma / Q000188:drug therapy / Q000235:genetics / Q000532:radiotherapy / Q000601:surgery; D001932:Brain Neoplasms / Q000150:complications / Q000188:drug therapy / Q000235:genetics / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000379:methods; D003399:Craniotomy; D004249:DNA Damage; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004827:Epilepsy / Q000188:drug therapy / Q000209:etiology; D005544:Forecasting; D005909:Glioblastoma / Q000188:drug therapy / Q000235:genetics / Q000532:radiotherapy / Q000601:surgery; D005910:Glioma / Q000150:complications / Q000188:drug therapy / Q000235:genetics / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D009363:Neoplasm Proteins / Q000235:genetics; D019853:O(6)-Methylguanine-DNA Methyltransferase / Q000235:genetics; D010166:Palliative Care; D011379:Prognosis; D011401:Promoter Regions, Genetic; D000077204:Temozolomide; D019851:Thrombophilia / Q000188:drug therapy / Q000209:etiology
D000925:Anticoagulants; D000927:Anticonvulsants; D018906:Antineoplastic Agents, Alkylating; D009363:Neoplasm Proteins; D003606:Dacarbazine; D019853:O(6)-Methylguanine-DNA Methyltransferase; D000077204:Temozolomide