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Temozolomide With or Without Radiotherapy in Melanoma With Unresectable Brain Metastases

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Summary

Brain metastases are a common complication in patients suffering from metastatic malignant melanoma. We analyzed efficacy and toxicity of the alkylating agent temozolomide with excellent CNS penetration and known activity in brain metastasis in 35 patients with unresectable melanoma brain metastases. Patients received 200 mg/m2 temozolomide on days 1 to 5 every 28 days as first or second-line therapy. This therapy regimen was combined with radiotherapy of the brain metastases in 22/35 patients. Grade III and IV toxicity was observed in 8/35 patients (leukopenia, granulocytopenia, thrombocytopenia, anemia, nausea and obstipation). Complete remission was observed in 1/34, partial remission in 2/34 and stable disease in 9/34 patients. In 5/34 a mixed response was assessed, 17/34 had disease progression and in one patient tumor response was not evaluable. The median progression free time was 5 (0–8) months for all patients, the median survival time for all patients from start of therapy was 8 (0–28) months, 9 (2–28) months in patients with concurrent stereotactic radiotherapy and 7 (3–17) months in patients with concurrent whole brain radiotherapy. Our results demonstrate that temozolomide can be combined with radiotherapy for the treatment of brain metastases in malignant melanoma, and that this combination may prolong survival in this patient group.

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Authors and Affiliations

  1. Department of Dermatology and Allergy, Charité-University Medicine Berlin, Schumannstrasse 20-21, 10117, Berlin, Germany

    Maja Hofmann, Felix Kiecker, Wolfram Sterry & Uwe Trefzer

  2. Department of Radiotherapy and Radiological Oncology, Charité-University Medicine Berlin, Berlin, Germany

    Reinhard Wurm, Lorenz Schlenger & Volker Budach

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  1. Maja Hofmann
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  2. Felix Kiecker
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  3. Reinhard Wurm
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  6. Wolfram Sterry
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  7. Uwe Trefzer
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Correspondence to Maja Hofmann.

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Hofmann, M., Kiecker, F., Wurm, R. et al. Temozolomide With or Without Radiotherapy in Melanoma With Unresectable Brain Metastases. J Neurooncol 76, 59–64 (2006). https://doi.org/10.1007/s11060-005-2914-0

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