Impacts of Temozolomide in Glioblastoma Patients

Abstract

Glioblastoma presents significant challenges due to its rapid growth, invasiveness, and impact on critical brain functions. Despite advancements in treatment, including the standard procedures of surgery, radiation, and chemotherapy, the tumor is accompanied by a five-year mortality rate of 95%. Temozolomide, a type of chemotherapy, is a key form of glioblastoma treatment but is associated with severe side effects, including immunosuppression, fatigue, and nausea/vomiting. Temozolomide-induced immunosuppression weakens the immune system by reducing white blood cell counts, making patients more susceptible to symptoms such as infections, slower healing, and increased vulnerability to pathogens and cancer cells. Nausea and vomiting are also common side effects of temozolomide, triggered by the activation of the chemoreceptor trigger zone (CTZ) in the brain's medulla oblongata. The CTZ detects harmful substances in the blood and signals the vomiting center to induce vomiting, often accompanied by symptoms like severe pain, headaches, dizziness, and weight loss due to water depletion. Temozolomide can also cause fatigue, leading to low energy, irritability, and muscle weakness due to the body's increased energy output on the extra strain in restoring homeostasis. The paper discusses the balance between extending life and maintaining quality of life, highlighting the difficult choices faced by glioblastoma patients. Future research is needed to develop interventions that mitigate these side effects or alternative treatments that provide similar efficacy with fewer side effects, ultimately improving both survival and quality of life for glioblastoma patients.