Ranhel C De Roxas, Cezar Thomas R Suratos and Marc Laurence L Fernandez
Background: With the advent of newer chemotherapeutic agents, the use of Temozolomide is becoming an option in the treatment of low-grade glioma (LGG). This systematic review aims to look into the available evidences on the efficacy of Temozolomide in the management of LGG and determine if it is a good and reasonable option for the patients.
Method: A literature search and systematic review was conducted primarily answering the question: “What is the efficacy of Temozolomide in the treatment of LGG?” A two-phase abstraction was utilized yielding a total of nine studies included in the review.
Results: Ten prospective single-arm studies were initially included but one study was adjudicated as having low quality. Nine studies involving 453 patients with LGG were included. In this review, the three-year overall survival of patients diagnosed with LGG who were given Temozolomide were noted to be high ranging from 73.1-82.0% while progression-free survival showed a wide variation across studies ranging from 11.0-98.0%. Reduction in seizure frequency was seen in 48- 62% of the patients. The occurrence of mild to moderate hematologic toxicity is quite common at 10-97%.
Conclusion: We conclude that Temozolomide showed consistently high overall survival and reduction in seizure frequency among patients diagnosed with LGG. Variable responses on objective radiologic response, quality of life and progression- free survival rates were noted. Future studies should look into the efficacy of Temozolomide as an adjunct or as an initial treatment in LGG with a comparison with a control group in order for more conclusions to be made.
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