A sequential chemo-radiotherapeutic treatment for patients with malignant gliomas: a phase II pilot study.
BACKGROUND
The purpose of our study was to evaluate the activity and toxicity of a sequential chemo-radiotherapeutic treatment on the basis of an earlier report by The Johns Hopkins Oncology Center.


METHODS
Eighteen patients with histologically diagnosed malignant gliomas entered the study. Fifteen patients had glioblastoma multiforme (83%). BCNU (40 mg/sqm/die) and Cisplatin (40 mg/sqm/die) were administered concurrently for 3 days every 3-4 weeks. Radiotherapy consisted of 45 Gy whole cranial irradiation plus a 15 Gy boost on the preoperative volume.


RESULTS
Thirteen patients had measurable disease and were evaluable for response. After chemotherapy we obtained 3 CRs (complete remission) and 4 PRs (partial remission) (RR (response rate 54%). Three PRs were converted to CRs after radiotherapy, for a complete remission rate of 46% (6/13). The median duration of response was 10 months. The median survival of the entire patients population was 9 months with 33% survival rates at 1 year. Hematological toxicity grade 4 in one patient and grade 3 in two patients were the major complications due to chemotherapy.


CONCLUSIONS
Our sequential chemo-radiotherapeutic regimen appears to have significant activity in adults with newly diagnosed high-grade gliomas.
Dazzi
C
C
Dipartimento di Oncologia ed Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy. c.dazzi@ra.nettuno.it
Cariello
A
A
Giannini
M
M
Del Duca
M
M
Giovanis
P
P
Fiorentini
G
G
Leoni
M
M
Rosti
G
G
Turci
D
D
Tienghi
A
A
Vertogen
B
B
Zumaglini
F
F
De Giorgi
U
U
Marangolo
M
M
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001254:Astrocytoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D009837:Oligodendroglioma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D010865:Pilot Projects; D012074:Remission Induction; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology
D002945:Cisplatin; D002330:Carmustine