title: Thalidomide as palliative treatment in patients with advanced secondary glioblastoma.
abstract: BACKGROUND
  For its numerous abilities including sedation, we have been using thalidomide (TH) as the 'last therapeutic option' in patients with advanced gliomas. We noticed that a small subgroup, i.e. patients with secondary glioblastoma (GBM, whose GBM has evolved over several months or years from a less malignant glioma), survived for prolonged periods. Therefore, we retrospectively evaluated the outcomes of patients with secondary GBM treated with TH at our centre.
  
  
  METHODS
  Starting in the year 2000, we have studied 23 patients (13 females, 10 males, with a median age of 31.5 years) with secondary GBM who have received palliative treatment with TH 100 mg at bedtime. All patients had previously undergone radiotherapy and received at least 1 and up to 5 regimens of chemotherapy.
  
  
  RESULTS
  The median duration of TH administration was 4.0 months (range 0.8-32). The median duration of overall survival after the start of TH therapy was 18.3 months (range 0.8-57). Eleven patients with secondary GBM survived longer than 1 year. Symptomatic improvement was most prominent in the restoration of a normal sleep pattern.
  
  
  CONCLUSIONS
  The palliative effects of TH, especially the normalization of a sleep pattern, were highly valued by patients and families. The prolongation of survival of patients with secondary GBM has not been reported previously.
authors.forename: Marco Ronald
authors.initials: MR
authors.lastname: Hassler
authors.forename: Cornelia
authors.initials: C
authors.lastname: Sax
authors.forename: Birgit
authors.initials: B
authors.lastname: Flechl
authors.forename: Michael
authors.initials: M
authors.lastname: Ackerl
authors.forename: Matthias
authors.initials: M
authors.lastname: Preusser
authors.forename: Johannes Andreas
authors.initials: JA
authors.lastname: Hainfellner
authors.forename: Adelheid
authors.initials: A
authors.lastname: Woehrer
authors.forename: Karin Ute
authors.initials: KU
authors.lastname: Dieckmann
authors.forename: Karl
authors.initials: K
authors.lastname: Rössler
authors.forename: Daniela
authors.initials: D
authors.lastname: Prayer
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000556:secondary*; D005910:Glioma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D010166:Palliative Care; D012189:Retrospective Studies; D012894:Sleep Stages / Q000187:drug effects; D016019:Survival Analysis; D013792:Thalidomide / Q000008:administration & dosage* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide