Temozolomide in the complex treatment of malignant gliomas in children and adults. The preliminary results. The literature review
Summary The results of the analysis of publications on the use temozolomide in the treatment of cerebral gliomas in adults and children, available in the Medline system over the past 10 years, showed a slight improvement in survival and recurrence-free flow at the hemispheric gliomas localizations. In inoperable tumors of the brain stem temozolomide does not improve the results of radiotherapy. It is established that the leading role in the effect of treatment of gliomas, including when using temozolomide, belongs clinical and biological factors: molecular characteristics of the tumor, the age and condition of the patient, the surgical volume. The main side effect when using temozolomide is myelodepression. Given the risk of its development, the unpredictability of the effect of the drug when used without regard to prognostic factors and high cost, it seems appropriate to abandon the standards of its application on the basis of histopathological data only, or only clinical and radiological diagnosis and use of individualized evidence-based important to predict the identified clinical and biological parameters and molecular characteristics of tumors. In further studies performance evaluation should be based on consideration of all prognostic factors.