Multifaceted Temozolomide Toxicity in Glioma: Detection & Care.

BACKGROUND: Gliomas are the most common malignant primary brain tumors, and Temozolomide (TMZ) remains a key component of their management. Despite its efficacy, TMZ is associated with adverse drug reactions (ADRs) that may affect quality of life and treatment compliance. This study evaluated the pattern and frequency of ADRs in South Indian glioma patients receiving TMZ, examined demographic associations, and reviewed management strategies. METHODS: A retrospective observational study was conducted at KMC Hospital, Mangalore, India, over the past three years. Thirty-eight patients with histologically confirmed glioma who received oral TMZ were included. Data on demographics, tumor characteristics, treatment schedules, hematological and non-hematological ADRs, management approaches, and outcomes were extracted from medical records and analyzed using SPSS. RESULTS: The study population was predominantly male (68.4%), with a median age of 45.5 years. Grade 3 and Grade 4 gliomas accounted for 31.6% and 34.2% of cases, respectively. A total of 38 ADRs were documented. The most frequent ADRs were leukocytopenia (9.3%) and itching (9.3%). Management strategies included treatment deferral, dose reduction, antihistamines, nonsteroidal anti-inflammatory drugs, and blood transfusions. Most ADRs resolved without hospitalization. Skin-related reactions typically subsided within 4-14 days, whereas hematological toxicities such as neutropenia required longer recovery periods (22-75 days). The mortality rate was low (5.3%), suggesting effective ADR management. CONCLUSION: TMZ-related ADRs in glioma patients are diverse, underscoring the need for vigilant monitoring of both hematological and non-hematological toxicities. Individualized management and careful tracking of recovery times can improve treatment tolerance and patient quality of life.