UICC World Cancer Congress 2006

Objective: High grade gliomas (HGG) are difficult to extirpate fully by surgery alone. Even after when post operative radiotherapy (RT) is given these tumors recur very fast. There is much requirement to accentuate the action of radiation therapy and need of an agent which can affect the tumor with its cytotoxic action.Temozolamide (TMZ) is an orally administrable alkylating agent which can cross blood brain barrier (BBB) and may possess synergistic effect with radiation therapy.

Methods:Post operative chemoradiotherapy (ChRT) was delivered to 22 patients of HGG. Single oral dose of 100 mg TMZ was administered 90 minutes before RT fraction during whole of RT course. RT was delivered by conventional fractionation to the total dose of 62 to 66 Gy. In 7 to 8 weeks time in 32 to 36 fractions. After completion all patients were given adjuant dose of TMZ 150 mg/ m2 for five doses in five days time every 28 days for 6 to 8 cycles. All 22 patients were followed up for atleast 18 months of duration.

Results:Marked improvement was seen in the quality of life during and after the completion of the treatment. 72.72 % patients survived for more then 6 months after completion of treatment. After an year 63.63 % were surviving with slow and study improvement in quality of life. 54.54 % patients were surviving after one year.There was definite improvement in survival with better performance status. No major systemic toxicity was seen except some mild nausea and vomiting sensation in some patients.