Abstract
Background
Late adjuvant therapy is the term to define the treatment administered following complete resection of metastatic or relapsed disease.
Objective
To assess the efficacy of single-agent temozolomide, a standard agent is used for metastatic melanoma in late adjuvant chemotherapy for cutaneous melanoma.
Methods
Twenty-seven adult cutaneous melanoma patients whose relapses were completely resected were included in this study. Temozolomide was administered as follows: peroral, 200 mg/m2 once daily for five consecutive days of a 28-day treatment cycle for six cycles.
Results
The median age was 55 years and men were predominant (74%). Median follow-up time was 23.6 months (range, 3.6–122.6 months). Any type of relapse occurred in 14 (51.9%) patients, and five patients relapsed while on chemotherapy. Almost all relapses (n = 13, 93%) occurred within the first two years of follow-up. The relapse rates were found 37.4 and 49.1% in the first and second years of follow-up, respectively. Moreover, after fifth year of onset of chemotherapy, relapse rate was found only 51.9%. The median relapse-free survival (RFS) was 12.9 months, and 1-, 2-, 3-, and 5-year RFS rates were 60, 46, 39, and 39%, respectively. The estimated median overall survival was 23.6 months. All patients survived first year (n = 27, 100%), and the overall survival rates for 2, 3, and 5 years were 81, 48, and 48%, respectively.
Conclusion
Single-agent temozolomide may be a rational and prudent option for late adjuvant therapy in melanoma patients if/when novel therapies, such as targeting and immune therapies, are not accessible or available.
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