211366 Temozolomide chemotherapy based on MGMT protein expression for patients with malignant gliomas:a report of 40 case

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/Yang Qunying(杨群英，State Key Lab Oncol，South China;Dept Neurosurg Neuroncol，Cancer Center，Sun Yat-sen Univ，Guangzhou 510060)…∥Chin J Neurosurg.-2011，27(2).-112 ～115

ObjectiveThis study is to evaluate the efficacy and toxicity of temozolomide(TMZ)chemotherapy based on O6-methylguanine-DNA methyltransferase(MGMT)protein expression in patients with malignant gliomas.MethodsA total of 40 patients with pathologically confirmed malignant gliomas were enrolled.All patients had pretreated with radiotherapy and had assessable lesions.MGMT protein expression were detected by immunohistochemical technique.Alternative schedules of TMZ were administered based on MGMT protein expression.Patients with MGMT negtive expression received 150～200 mg/m2TMZ on days 1-5.Patients with MGMT postive expression received 75 mg/m2TMZ on days 1-21 or 150～200 mg/m2TMZ on days 2-6 combined with Cisplatin(DDP)40 mg/m2on days 1-2.ResultsAmong 22 patients with MGMT negative expression and 18 patients with MGMT positive expression，the response rate was 31.8%and 33.3%(P ＞0.05)，the median progressionfree survival time was 7 months(95%CI:5.7-8.3)and 7 months(95%CI:2.3-11.7)，the median survival time was 24 months(95%CI:12.7-35.3)and 11.5 months(95%CI:9.9-11.3)，respectively.There were no significant differences(P ＞0.05).The most common toxicities were gradeⅠ～Ⅱneutropenia(20%)，decreased appetite(30%)，nausea and vomitting(22%)and elevated liver enzymes(25%).ConclusionAlternative schedules of TMZ may improve efficacy in patients with MGMT positive expression tumors，toxicities are tolerable.16 refs，3 figs，1 tab.