Abstract
The treatment for malignant tumors in the central nervous system (CNS) mainly consists of surgical resection followed by adjuvant radiation and chemotherapy. Temozolomde (TMZ), a second-generation of oral alkylating agent, plays an increasingly important role in the treatment of malignant glioma in China. However, the history of TMZ use in China, has not been well reviewed. In this study, an extensive literature search of Pubmed and major Chinese electronic databases was performed to identify clinical reports on TMZ use in mainland China. We found that TMZ is a standard addition to postoperative RT for glioblastoma, followed by 6 cycles of adjuvant treatments as Chinese and NCCN guidelines recommended. But since TMZ is relatively expensive to most Chinese patients, especially in undeveloped areas, some other regimens are still commonly used. It is also indicated for relapsed or Grade III glioma, with some potential value in brain metastasis and primary central nerve lymphoma. Extended use or combination therapy including TMZ may benefit more for glioma patients. As the clinical trials have been paid more attention in the recent years, effort and collaboration should be made to conduct well-designed multicenter randomized clinical trials on TMZ, with the aim of improving the prognosis of patients with CNS tumor in mainland China.
Highlights
Chemotherapy for central nervous system (CNS) tumor first became available in the 1950s and reports from the related clinical studies appeared in the early 1970s in China [1]
Temozolomide (TMZ) is an orally administered alkylating agent used for treatment of glioblastoma multiforme (GBM) with significantly improved efficacy and safety, which is presently the first-line chemotherapy for patients with malignant glioma in China
We reviewed the literatures and identified clinical studies reporting outcomes of CNS tumor patients treated with chemotherapy in mainland China
Summary
Chemotherapy for central nervous system (CNS) tumor first became available in the 1950s and reports from the related clinical studies appeared in the early 1970s in China [1]. The application of these agents attained only modest effect on improving patient survival [3]. Temozolomide (TMZ) is an orally administered alkylating agent used for treatment of glioblastoma multiforme (GBM) with significantly improved efficacy and safety, which is presently the first-line chemotherapy for patients with malignant glioma in China. It is a standard addition to postoperative RT for GBM, followed by 6 cycles of adjuvant TMZ. Nowadays it is indicated for relapsed high-grad glioma and not indicated for, and replacing the older (and less well tolerated) PCV (ProcarbazineLomustine-Vincristine) regimen for oligodendroglioma in some places.
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