Temozolomide in patients with melanoma brain metastases treated with whole brain irradiation

BACKGROUND AND OBJECTIVE: Whole brain irradiation (WBRT) remains a recommended treatment for patients with brain metastases from malignant melanoma. Temozolomide (TMZ) displays efficacy for the treatment of metastatic melanoma. Our objective was to evaluate the potential benefit of TMZ administered along with WBRT. PATIENTS AND METHOD: We have conducted a retrospective study in a group of 26 patents comparing WBRT (n = 10) (20 Gy/5 fr) with WBRT+TMZ (n = 16) administered as a single chemotherapeutic agent (200 mg/m(2)) or in combination with chemoimmunotherapy (150 mg/m(2)). RESULTS: The median survival of the total group (n = 26) was 3 months (Cl 95%, 2-4 months). The median survival of the WBRT+TMZ group was 6 months (Cl 95%, 0-12 months), while the median survival of the WBRT group was 1 month (Cl 95%, 1-2 months) (p < 0.0001). The analysis of survival at different time intervals (90, 180 and 270 days) showed a clear benefit for the group treated with WBRT + TMZ (p = 0.016). CONCLUSIONS: These results suggests a benefit of TMZ added to WBRT in terms of long-term survival for patients with melanoma brain metastases.