title: Phase II study of temozolomide and concomitant whole-brain radiotherapy in patients with brain metastases from solid tumors.
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.
  
  
  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.
  
  
  CONCLUSIONS
  WBI combined with TMZ as concomitant and adjuvant treatment is effective in treating brain metastases, with acceptable mild side effects.
authors.affiliation: Department of Radiation Oncology, University of Athens, Greece. johnkouv@aretaieio.uoa.gr
authors.forename: John R
authors.initials: JR
authors.lastname: Kouvaris
authors.forename: Anthi
authors.initials: A
authors.lastname: Miliadou
authors.forename: Vassilis E
authors.initials: VE
authors.lastname: Kouloulias
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kolokouris
authors.forename: Myrsini J
authors.initials: MJ
authors.lastname: Balafouta
authors.forename: Xenofon N
authors.initials: XN
authors.lastname: Papacharalampous
authors.forename: Lambros J
authors.initials: LJ
authors.lastname: Vlahos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D017322:Clinical Trials, Phase II as Topic; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D010166:Palliative Care; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D012107:Research Design; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide