title: Survival over 6 years in a patient with brain metastases from melanoma treated with temozolomide.
abstract: Cerebral metastases from melanoma are generally associated with a dismal prognosis with survival ranging from 3 to 6 months after treatment. Systemic chemotherapy for these patients has limited effect and evidence for an overall survival benefit from randomised controlled trials is lacking. We report on a 59-year-old patient with a history of malignant melanoma who presented with multiple cerebral metastases after previous surgery and combined whole brain and stereotactic radiotherapy. She has been in sustained remission and in excellent clinical condition after treatment with continued cycles of oral temozolomide for more than 6 years. To our knowledge, similar prolonged survival has been described only once in patients with multiple cerebral metastases from melanoma. This case demonstrates that temozolomide for metastatic central nervous system (CNS) disease in melanoma patients may be highly effective without CNS toxicity.
authors.affiliation: Medical Center Haaglanden, Den Haag, The Netherlands. j.koekkoek@mchaaglanden.nl
authors.forename: Johan A F
authors.initials: JA
authors.lastname: Koekkoek
authors.forename: Ruud G
authors.initials: RG
authors.lastname: Wiggenraad
authors.forename: Hanneke
authors.initials: H
authors.lastname: Zwinkels
authors.forename: Hendrika M
authors.initials: HM
authors.lastname: Oosterkamp
authors.forename: Martin J B
authors.initials: MJ
authors.lastname: Taphoorn
authors.forename: Rianne M
authors.initials: RM
authors.lastname: Oosterkamp
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000494:pharmacology / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects* / Q000473:pathology / Q000601:surgery; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide