Radiotherapy plus concomitant and adjuvant temozolamide for newly diagnosed pediatric high-grade astrocytoma

Abstract

9042 Background: to evaluate the potential survival advantage of adding temozolamide (TMZ) concomitantly and adjuvant to radiotherapy (RT) as regard time to progression (TTP) and overall survival in addition to its safety and tolerability in pediatric high grade astrocytomas. Methods: A total of 29 pediatric patients newly diagnosed, histologically proven glioblastoma multiforme (GBM) or anaplastic astreocytoma (AA) were randomized, to radiotherapy alone (14 patients) or radiotherapy and concomitant (TMZ) 150mg/m2/d for 5 days every 28 days followed by up to 6 cycels of adjuvant TMZ (15 patients). Results: The median time to progression was significantly prolonged in patients treated with RT/TMZ compared to those treated with RT alone (14 months Vs 7 months respectively) (P<0.05). The median overall survival in the combined treatment Vs monotherapy was 23 months and 13 months respectively (P<0.01). Non hematologic adverse events were similar between both groups while grade 3 & 4 hematologic toxicities occurred in 20% only of the RT/TMZ arm (2 patients experienced grade 3 thrombocytopenia and 1 patient developed grade 4 neutropenia). Conclusions: This study demonstrate a significant survival benefit for the addition of TMZ to treatment of pediatric patients with high grade astrocytpoma and it’s safety, well tolerability which allows it to be given concurrently with RT, followed by additional adjuvant cycles. No significant financial relationships to disclose.