Preradiation intracarotid cisplatin treatment of newly diagnosed anaplastic gliomas. The CNS Cancer Consortium.
OBJECTIVE
This phase II study was performed to assess the response of patients with newly diagnosed, untreated malignant gliomas (anaplastic astrocytoma [AA] and glioblastoma multiforme [GBM]) to intracarotid (IC) cisplatin.


METHODS
Eligibility criteria included surgical intervention limited to biopsy only, measurable contrast-enhancing tumor, and unilateral tumor location within the vascular territory of one internal carotid artery. Patients were scheduled to receive four infusions of IC cisplatin (75 mg/m2 every 4 weeks) before beginning standard radiotherapy. Twenty-six patients were treated, and 22 were assessable for response.


RESULTS
Ten patients (45%) showed a greater than 25% decrease in the enhancing tumor area before radiotherapy with stabilization or improvement of neurologic deficits, and three patients (14%) had a greater than 70% decrease in tumor area. The likelihood of response to IC cisplatin was not clearly linked to patient age, tumor histology, or pretreatment tumor size. Myelosuppression, nephrotoxicity, and ototoxicity were mild. Optic neuropathy occurred in one patient, seizures in two, and fatal postinfusion cerebral edema in one.


CONCLUSIONS
This study design, which permits assessment of the drug sensitivity of the untreated glioma, has shown definite antitumor activity of IC cisplatin in newly diagnosed malignant glioma patients.
Dropcho
E J
EJ
Department of Neurology, University of Albama, Birmingham 35294.
Rosenfeld
S S
SS
Morawetz
R B
RB
Vitek
J
J
Brothers
M
M
Gorum
T
T
Bell
S
S
Gillespie
G Y
GY
Glantz
M
M
Mahaley
M S
MS
D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000188:drug therapy* / Q000532:radiotherapy; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D002339:Carotid Arteries; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004341:Drug Evaluation; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D007261:Infusions, Intra-Arterial; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
D002945:Cisplatin