Temozolomide chemotherapy is a treatment regimen given to patients with specific types of brain cancer, often in combination with radiotherapy. This medication is an antineoplastic that appears to interfere with cancer cell growth. The treatment regimen is classified as a cytotoxic chemotherapy because this drug also affects normal cell growth, although these healthy cells can normally repair the damage. Temozolomide chemotherapy may also be used to treat metastatic melanoma and malignant gliomas in children. It is marketed under the brand names Temodar®, Temodal®, and Methazolastone.
Chemotherapy drugs are either administered into a vein or as tablets or capsules. Temozolomide chemotherapy is an oral chemotherapy because patients take capsules whole every day with a full glass of water and on an empty stomach, often at home rather than in a hospital or clinic. If the capsule is accidentally opened, the powder inside should not come into contact with the skin, mouth, or nose. The dosing and amount of temozolomide chemotherapy is different for each patient, but the capsules range from 5 to 250 milligrams.
Temozolomide is indicated for the treatment of adult patients with newly diagnosed glioblastoma multiforme and refractory anaplastic astrocytoma. Both are aggressive types of brain tumors. The median survival time for patients with glioblastoma multiforme is approximately 14 months and 18 months for those with anaplastic astrocytoma.
This treatment is a type of antineoplastic. It works by damaging and triggering the death of tumor cells, but can also affect healthy cells. Healthy cells can repair the damage caused by temozolomide chemotherapy, while cancer cells often cannot. In clinical trials, patients receiving temozolomide plus radiotherapy lived an average of 14.6 months versus 12.1 months for those receiving only radiotherapy.
Every patient will experience a unique reaction to temozolomide chemotherapy. Nausea and vomiting are very common side effects. It is also likely that the patient’s white and red blood cell counts will be reduced, making him or her more vulnerable to infection and possibly anemic. A blood test is usually done between treatment sessions to ensure that a patient’s white blood cells have adequately recovered before the next dose. Other typical side effects include loss of appetite, rashes, and tiredness or weakness.
Some patients experience side effects that are less common. In rare cases, a patient’s hair will thin or fall out completely. This is temporary, and the hair will regrow once treatment is complete unless the hair loss is due to radiotherapy. Hair loss caused by radiotherapy may be permanent. Fever and chills are also typically temporary, but instances of dizziness and breathlessness should be reported to a doctor.
A course of temozolomide chemotherapy includes several cycles or sessions of treatment. These cycles typically last a few months with rest periods in between. The number and length of cycles depends on various factors, including the type of cancer treated and how well the patient tolerates the medication. As with any medication, patients and their doctors should discuss all risks and benefits of temozolomide chemotherapy before starting treatment.