Primary spinal cord glioblastoma multiforme treated with temozolomide

Area of Science:

• Neuro-oncology
• Oncology
• Neurosurgery

Background:

• Primary spinal cord glioblastoma multiforme (SC GBM) is a rare and challenging diagnosis.
• Established treatment guidelines exist for cranial GBM but not for SC GBM.
• The efficacy of temozolomide (TMZ) in SC GBM remains largely unevaluated.

Purpose of the Study:

• To systematically review and evaluate the efficacy of temozolomide (TMZ) in the treatment of primary spinal cord glioblastoma multiforme (SC GBM).
• To compare survival outcomes between SC GBM patients treated with and without TMZ.

Main Methods:

• Systematic literature review using Medical Subject Headings (MeSH) terms: 'glioblastoma' and 'primary spinal cord neoplasms, intramedullary'.
• Stratification of studies into TMZ and non-TMZ treatment groups.
• Survival analysis using the Kaplan-Meier method with a two-sided log-rank test.

Main Results:

• The TMZ subgroup included 19 patients from 9 articles; the non-TMZ group included 45 patients from 19 articles.
• Median overall survival was 16 months in the TMZ group versus 10 months in the non-TMZ group.
• The difference in survival between the groups was not statistically significant (p = 0.57).

Conclusions:

• While not statistically significant, a trend towards longer survival was observed in SC GBM patients treated with TMZ.
• The limited number of patients in reviewed studies likely contributed to the lack of statistical significance.
• A multi-institutional, prospective, controlled study is warranted to definitively assess TMZ's role in SC GBM treatment.