Response and progression in recurrent malignant glioma.
In this article we report the results of a study of the relationship between response and progression in 375 patients with recurrent glioma enrolled in phase II chemotherapy trials. We reviewed the records of patients from 8 consecutive phase II trials, including 225 patients with recurrent glioblastoma multiforme and 150 with recurrent anaplastic astrocytoma. Median age was 45 years (range, 15-82) and median Karnofsky performance score was 80 (range, 60-100). Forty-one patients (11%) had more than two prior resections and/or more than two prior chemotherapy regimens. Best response was complete (n = 1) or partial (n = 33) in 34 patients (9%). Median time to response was 14 weeks, and median response duration was 44 weeks. Simon-Makuch estimates for 52-week progression-free survival for patients progression-free at 13 weeks were 48% for response and 28% for nonresponse. When response was treated as a time-dependent covariate in a Cox proportional hazards regression analysis, response was associated with significantly lower failure rates (hazard ratio 0.5; 95% confidence interval 0.3-0.8; P = 0.0016). This study showed that response in recurrent glioma is associated with a significant reduction in progression rates.
Hess
K R
KR
Department of Biomathematics, Box 237, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
Wong
E T
ET
Jaeckle
K A
KA
Kyritsis
A P
AP
Levin
V A
VA
Prados
M D
MD
Yung
W K
WK
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077556:Alitretinoin; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001254:Astrocytoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D016190:Carboplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D000518:Eflornithine / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005909:Glioblastoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D005910:Glioma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D006801:Humans; D016899:Interferon-beta / Q000008:administration & dosage; D008297:Male; D017290:Menogaril / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality; D011344:Procarbazine / Q000008:administration & dosage; D011379:Prognosis; D016016:Proportional Hazards Models; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage
D000077556:Alitretinoin; D011344:Procarbazine; D014212:Tretinoin; D016899:Interferon-beta; D017290:Menogaril; D016190:Carboplatin; D005472:Fluorouracil; D000518:Eflornithine