Intra-arterial ACNU and carboplatin versus intravenous chemotherapy with cisplatin and BCNU in newly diagnosed patients with glioblastoma.
Thirty glioblastoma patients treated at our institute between April 1998 and September 1999 were randomized in a two-arm study to receive carboplatin plus ACNU intraarterial (IA) chemotherapy (arm A) or cisplatin plus BCNU intravenous (IV) treatment (arm B). After the second course of chemotherapy and before the third cycle they also received concomitant radiotherapy, consisting of a median dose of 56.5 Gy. There were 3 (21.4%) partial responses and 11 (78.6%) disease stabilizations in group A. There were 5 (33%) partial responses and 10 disease stabilizations in group B. Time to tumor progression was 5.2 and 5.8 months for IA and IV treatment respectively. Median survival time was 18.3 months for arm A patients and 18.6 for arm B patients. Our IA chemotherapy schedule has produced no conclusive evidence of benefit compared with intravenous treatment. Moreover, its cost-benefit ratio is not good enough to justify its continued pursuit.
Silvani
A
A
Department of Neuro-oncology, Istituto Nazionale Neurologico Carlo Besta, Via Celoria 11, I-20133 Milan, Italy.
Eoli
M
M
Salmaggi
A
A
Erbetta
A
A
Fariselli
L
L
Boiardi
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use*; D002330:Carmustine / Q000008:administration & dosage / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D004333:Drug Administration Routes; D005260:Female; D005909:Glioblastoma / Q000628:therapy*; D006801:Humans; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D017567:Karnofsky Performance Status / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015376:Nimustine / Q000008:administration & dosage / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D015376:Nimustine; D016190:Carboplatin; D002945:Cisplatin; D002330:Carmustine