A case series of salvage CCNU in high-grade glioma who have previously received temozolomide from a tertiary care institute in Mumbai.

Abstract:

INTRODUCTION:In our center, we routinely use CCNU (Lomustine) as salvage treatment in high-grade glioma patients who cannot afford bevacizumab. This exploratory analysis was done to report the efficacy and toxicity associated with this regimen. METHODS:Patients who were treated with salvage CCNU (postexposure to temozolomide) between January 2015 and August 2016 were included for this retrospective analysis. SPSS version 16 was used for this analysis. Time-to-event analysis was performed using the Kaplan-Meier method. Progression-free survival (PFS) and overall survival (OS) were estimated. The maximum grade of toxicity during salvage CCNU was noted in accordance with CTCAE version 4.02. RESULTS:In the stipulated period, 16 patients were selected for the analysis. The median age of patients was 43 years (range 15-63 years), and 12 (80.0%) patients were males. The Eastern Cooperative Oncology Group performance status was 0-1 in 11 patients (73.3%) and 2-4 in 4 patients (26.7%). The tumor histopathology at diagnosis was glioblastoma in ten patients (66.6%), anaplastic astrocytoma in four (26.7%) patients, and anaplastic oligodendroglioma in one patient (6.7%). Grade 3-4 myelosuppression was seen in five patients (33.3%). The median PFS and OS were 192 days (95% confidence interval [CI]: 156.0-227.5 days) and 282 days (95% CI: 190.9-373.1 days), respectively. CONCLUSION:CCNU is associated with modest treatment outcomes in recurrent/relapsed high-grade gliomas. The high rate of myelosuppression is a concern. Urgent efforts are required to improve upon these results.

journal_name

Indian J Cancer

journal_title

Indian journal of cancer

authors

Patil VM,Abhinav R,Tonse R,Epari S,Gupta T,Jalali R

doi

10.4103/0019-509X.204774

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

558-561

issue

4

eissn

0019-509X

issn

1998-4774

pii

IndianJournalofCancer_2016_53_4_558_204774

journal_volume

53

pub_type

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