title: Temozolomide in relapsed pediatric brain tumors: 14 cases from a single center.
abstract: OBJECTIVE
  Temozolomide is an active drug against gliomas in adults. It also has some promising effects in pediatric patients with brain tumors. We have conducted a retrospective study to investigate the effectiveness of temozolomide in patients with relapsed brain tumors.
  
  
  METHODS
  The files of 14 children treated at our hospital between 2005 and 2010 with the diagnoses of relapsed brain tumors were reviewed for pathological characteristics, treatment results, and outcomes.
  
  
  RESULTS
  The median age at relapse was 8 years (range, 1.08-23; F/M, 5/9). Diagnoses included medulloblastoma (n = 5), atypical teratoid rhabdoid tumor (n = 2), ependymoma (n = 2), glioneuronal tumor (n = 1), malignant neoplasm (n = 1), pontine glioma (n = 1), astrocytoma grade III (n = 1), and glioblastoma multiforme (n = 1). All patients except the one with pontine glioma had undergone surgical resection, and all had prior adjuvant chemotherapy. Twelve out of 14 patients had received radiotherapy. The median number of temozolomide courses was 5.0 (range, 1-24). Objective response rate in our patients was 35.7% (three complete responses, one partial response, and one minor response). Stable disease achieved in 14.3% of patients and 50% had progressive disease. Median survival time was 8 months (range, 1-55). At the end of the study, three patients were alive. Hematological toxicity was seen in 30.8% of all courses.
  
  
  CONCLUSIONS
  Relapsed brain tumors in childhood have an unfavorable prognosis. These data suggest that temozolomide might be an active agent against recurrent medulloblastoma. Although overall objective response rate was low, further multicentric studies with temozolomide may be warranted in children with recurrent brain tumors.
authors.affiliation: Institute of Oncology, Department of Pediatric Oncology, Hacettepe University, 06100 Ankara, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Akyüz
authors.forename: Haci Ahmet
authors.initials: HA
authors.lastname: Demir
authors.forename: Ali
authors.initials: A
authors.lastname: Varan
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Yalçin
authors.forename: Tezer
authors.initials: T
authors.lastname: Kutluk
authors.forename: Münevver
authors.initials: M
authors.lastname: Büyükpamukçu
mesh_terms: D000293:Adolescent; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D012189:Retrospective Studies; D000077204:Temozolomide; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide