Abstract:
PURPOSE:The poor results from treatment of high grade glioma prompted us to explore new protocols involving concurrent radio-chemotherapy. Our primary objective was to evaluate the feasibility of very early postoperative chemotherapy with BCNU, concurrent radio-chemotherapy with carboplatin and teniposide, and post-radiotherapy BCNU. Our secondary objectives were to evaluate time to progression, and overall survival. PATIENTS AND METHODS:We treated 24 newly diagnosed patients (pts) with BCNU 150 mg/m2 seven days after surgery. Thirty days later, we started radiotherapy, 1.8 to 2 Gy/day for 5 days a week on limited fields up to 60 Gy, and concurrent chemotherapy with carboplatin 250 mg/m2 on days 1, 22, and 43, and teniposide 50 mg/m2 on days 1, 2, 3, 22, 23, 24, 43, 44 and 45. Two cycles of 150 mg/m2 BCNU were then given at 30 and 70 days, respectively, after the end of the radio-chemotherapy course. Therapy was then suspended, but if disease progression was evident, treatment was resumed with drugs that had not been previously employed. Surgical reintervention was not routinely considered. RESULTS:Following radio-chemotherapy treatment in the 24 pts evaluable for response, we observed partial remissions in 8 cases (33%) and stable disease in 12 (50%). Actuarial estimates of progression free survival (PFS) were 33 weeks, with 56 wks for anaplastic astrocytoma and 31 weeks for glioblastoma. Median survival time (MST) of all pts was 58 weeks; 51 weeks for glioblastoma and was not reached for anaplastic astrocytoma. This regimen was feasible. Of 144 planned cycles, 139 were delivered, and among these only in 13 and 9 cycles the doses were reduced by 75 and 50%, respectively. We did not observe any gastrointestinal toxicity. Grade 2 hematological toxicity occurred in 25% of pts. grade 3 in 4% and neurological toxicity in 3% of the pts during BCNU delivery, probably due to a sharp increase in intracranial pressure. CONCLUSION:Early chemotherapy, concurrent chemo-radiotherapy and brief post-radio-therapy chemotherapy are feasible and well tolerated. The objective response and disease stabilization rates appear similar to previous experiences.
journal_name
J Neurooncoljournal_title
Journal of neuro-oncologyauthors
Brandes AA,Rigon A,Zampieri P,Scelzi E,Amistà P,Berti F,Rotilio A,Gardiman M,Fiorentino MVdoi
10.1007/BF00177276subject
Has Abstractpub_date
1996-12-01 00:00:00pages
247-55issue
3eissn
0167-594Xissn
1573-7373journal_volume
30pub_type
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journal_title:Journal of neuro-oncology
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更新日期:1983-01-01 00:00:00
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journal_title:Journal of neuro-oncology
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更新日期:1985-01-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
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更新日期:1987-01-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章,评审
doi:10.1007/BF00165526
更新日期:1991-12-01 00:00:00
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journal_title:Journal of neuro-oncology
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更新日期:2007-04-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章,多中心研究
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abstract::Ependymomas are glial neoplasms originating from the wall of the ventricles or from the spinal canal. The significance of histopathological features in accurately predicting biological behavior is still debated. Moreover, key molecular events in the pathogenesis of ependymoma are yet to be defined. The main objective ...
journal_title:Journal of neuro-oncology
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