title: Dual Anti-angiogenic Chemotherapy with Temozolomide and Celecoxib in Selected Patients with Malignant Glioma Not Eligible for Standard Treatment.
abstract: OBJECTIVE
  Due to their high rate of neo-angiogenesis, malignant gliomas may qualify for treatment with anti-angiogenic substances. We report on a series of patients with malignant glioma not eligible for standard postoperative combined radiochemotherapy due to decreased health status.
  
  
  METHODS
  A total of nine patients with malignant glioma, postoperatively presenting with a Karnofsky performance score (KPS) below 70, were treated with standalone metronomic low-dose chemotherapy with temozolomide and celecoxib (cyclo-oxygenase-2 inhibitor). Overall survival was defined as the primary end-point and the functional status (KPS) and time to progression as secondary end-points of our analysis.
  
  
  RESULTS
  The median KPS after surgery was 60. Treatment achieved a decrease in tumor and edema volume and, more importantly, preserved the functional status defined as the ability to care for self (KPS 70%) until disease progression. No notable side-effects were recorded.
  
  
  CONCLUSIONS
  In patients with decreased general condition (KPS <70), not eligible for standard treatment, anti-angiogenic therapy offers a reasonable alternative approach. Our results indicate prolonged survival and preserved quality of life in comparison to best supportive care.
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Kerschbaumer
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Franziska Anna
authors.initials: FA
authors.lastname: Schmidt
authors.affiliation: Department of Neuroradiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Astrid Ellen
authors.initials: AE
authors.lastname: Grams
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Martha
authors.initials: M
authors.lastname: Nowosielski
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pinggera
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Konstantin Robert
authors.initials: KR
authors.lastname: Brawanski
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Ondra
authors.initials: O
authors.lastname: Petr
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Claudius
authors.initials: C
authors.lastname: Thomé
authors.affiliation: Department of Neurosurgery, Klinikum Idar-Oberstein, Idar-Oberstein, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Tuettenberg
authors.affiliation: Department of Neurosurgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Seiz
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria christian.freyschlag@uki.at.
authors.forename: Christian Franz
authors.initials: CF
authors.lastname: Freyschlag
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D000068579:Celecoxib / Q000009:adverse effects / Q000627:therapeutic use*; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005910:Glioma / Q000098:blood supply* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D017567:Karnofsky Performance Status; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D000077204:Temozolomide; D013997:Time Factors; D047368:Tumor Burden
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D003606:Dacarbazine; D000068579:Celecoxib; D000077204:Temozolomide
keywords: Glioblastoma; celecoxib; dual anti-angiogenic chemotherapy; temozolomide