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Up-front chemotherapy temozolomide in the treatment of Gliomatosis Cerebri: Analysis of 33 patients

Al Musella's Comments: (This is his personal views and are not necessarily the views of the Musella Foundation!)


Posted on: 06/14/2003

39th ASCO Annual Meeting • Chicago, IL • May 31-June 3, 2003 (Abstract No. 458)

Up-front chemotherapy temozolomide in the treatment of Gliomatosis Cerebri: Analysis of 33 patients

M. Sanson, K. Djazouli, L. Djafari, M. Napolitano, H. Gervais, K. Hoang-Xuan, K. Mokhtari, J. Cougnard, A. Hasbini, J.-Y. Delattre

Pitie-Salpetriere, Paris, France

Gliomatosis Cerebri (GC) is defined by a diffuse neoplastic glial cell infiltration involving at least two lobes of the brain, with preservation of architecture and sparing of neurones.

It may appear de novo (primary GC) or result from the spreading of a focal glioma (secondary GC).

Since surgery is not suitable and radiotherapy results in substantial toxicity, up-front chemotherapy warrants further investigation. Thirty-three GC were diagnosed: 19 males/14 females, median age 50.7 years (range 25-74), median IK=83 (range 50-100).

Out of the 24 primary GC (18 oligodendrogliomas, 1 oligoastrocytoma, 3 astrocytomas, 2 undetermined), 14 were grade 2, 6 were grade 3, 4 could not be graded.

Nine were secondary GC arising 2 to 21 years (median 4,-6 years) after treatment of a previously diagnosed glioma (8 grade 2, one grade 3) including 6 oligodendrogliomas, 1 oligoastrocytoma, 2 astrocytomas.

All the patients were treated with temozolomide (150 to 200 mg/m2 for 5 days every 4 weeks) for 2 to 23 courses (mean: 11.1).

Toxicity (NCI) evaluated during 367 total administred cycles: Thrombopenia and neutropenia grade 3-4 were observed in 5/367 cycles and 2/367 respectively. A clinical (8) or radiological response (9) was observed in 10/33 patients (30%); tumoral progression during the first three months of treatment was observed in 5 patients.

For all the patients, median time to progression was 11.9 months and overall survival time was 24.2 months.

In conclusion, up-front temozolomide chemotherapy of GC is well tolerated and results in a substantial rate of clinical and radiological improvement.

© Copyright 2003 American Society of Clinical Oncology All rights reserved worldwide Source:,1003,_12-002489-00_18-002003-00_19-00103989-00_29-00A,00.asp?cat=CNS+Tumors&parent= Central+Nervous+System+Tumors&returnpid=2325&SubCat_ID=4

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