Survival with dacarbazine and fotemustine in newly diagnosed glioblastoma multiforme.
A total of 55 patients with histologically proven glioblastoma multiforme (total gross resection: n=24, subtotal resection: n=20, stereotactic biopsy: n=11) were treated with the combination of dacarbazine (D) (200 mg m(-2)) and fotemustine (F) (100 mg m(-2)) and concomitant radiotherapy (2 Gy day(-1), 5 days per week using limited fields up to 60 Gy) to assess efficacy and toxicity of this regimen. Survival (median survival, 12-, 18- and 24-month survival rates) and time to progression (median time to progression (TTP), 6-month progression-free survival) were analysed by Kaplan-Meier's method. A total of 268 (range 1-8, median: 5) cycles were administered. Median survival is 14.5+ (range: 0.5-40+) months, and the 12-, 18- and 24-month survival rates are 58, 29 and 23%, respectively. Median TTP from the start of D/F therapy is 9.5+ (range: 0.5-33+) months. The 6-month progression-free survival is 54%. Partial remissions were observed in 3.6%. Main toxicity was thrombocytopenia. Five patients were excluded from further D/F application, four patients because of prolonged thrombocytopenia NCI-CTC grades 3 and 4 and one patient because of whole body erythrodermia. One patient died because of septic fever during thrombocytopenia and leukopenia NCI-CTC grade 4 after the first cycle. No other toxicities of NCI-CTC grade 3 or 4 occurred. The treatment is feasible in a complete outpatient setting and the results of the D/F regimen justify further investigations with these compounds.
Fazeny-Dörner
B
B
Clinical Division of Oncology and Ludwig Boltzmann Institute for Clinical and Experimental Oncology, Department of Internal Medicine I, University of Vienna, Austria. barbara.doemer@chello.at
Veitl
M
M
Wenzel
C
C
Rössler
K
K
Ungersböck
K
K
Dieckmann
K
K
Piribauer
M
M
Hainfellner
J
J
Marosi
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D003606:Dacarbazine / Q000009:adverse effects* / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009607:Nitrosourea Compounds / Q000009:adverse effects* / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000009:adverse effects* / Q000627:therapeutic use*; D016019:Survival Analysis; D015996:Survival Rate
D009607:Nitrosourea Compounds; D009943:Organophosphorus Compounds; D003606:Dacarbazine; C054368:fotemustine