title: Efficacy and feasibility of standard procarbazine, lomustine, and vincristine chemotherapy in anaplastic oligodendroglioma and oligoastrocytoma recurrent after radiotherapy. A Phase II study.
abstract: BACKGROUND
  To the authors' knowledge, there is a scarcity of accurate data regarding the feasibility of standard chemotherapy with procarbazine, lomustine, and vincristine (PCV) in a homogeneous series of patients with primary anaplastic oligodendroglioma (AO) and oligoastrocytoma (AOA) that was recurrent after surgery and standard radiotherapy. The aim of the current study was to evaluate the overall response rate, toxicity, and time to progression (TTP) with the use of standard PCV in this setting.
  
  
  METHODS
  Between November 1994 and September 2000, 37 patients were enrolled in the current study. Of these, 23 had AO (62%) and 14 had AOA (38%). All patients received standard PCV comprised of lomustine (110 mg/m2) on Day 1, procarbazine (60 mg/m2) on Days 8-21, and vincristine (1.4 mg/m2, maximum total 2 mg) on Days 8 and 29. Cycles were repeated every 6 weeks.
  
  
  RESULTS
  There were 11 complete responses (CR; 29.7%) and 11 partial responses (PR; 29.7%) reported and 8 patients had stable disease (SD; 21.6%). The response rate was higher in patients with AO compared with patients with AOA (77.2% vs. 22.7%; P = 0. 02). The median TTP, which was 12.3 months overall, was 30.3 months in patients who achieved a CR, 19.1 months in patients who achieved a PR, and 6.1 months in patients with SD. The median TTP was 18.6 months in AO patients and 6.14 in AOA patients. There were no cases of severe toxicity reported although in 16 patients (43%) who were free of disease progression, PCV was discontinued because of toxicity or inadequate recovery after 2 weeks of delay.
  
  
  CONCLUSIONS
  PCV chemotherapy was reported to achieved a high response rate and TTP but incurred a high risk of persistent toxicity.
authors.affiliation: Department of Medical Oncology, Azienda Ospedale-Università of Padova, Padova, Italy. aabrandes@unipd.it
authors.forename: Alba Ariela
authors.initials: AA
authors.lastname: Brandes
authors.forename: Alicia
authors.initials: A
authors.lastname: Tosoni
authors.forename: Francesca
authors.initials: F
authors.lastname: Vastola
authors.forename: Lara Maria
authors.initials: LM
authors.lastname: Pasetto
authors.forename: Bartolomea
authors.initials: B
authors.lastname: Coria
authors.forename: Daniela
authors.initials: D
authors.lastname: Danieli
authors.forename: Paolo
authors.initials: P
authors.lastname: Iuzzolino
authors.forename: Marina
authors.initials: M
authors.lastname: Gardiman
authors.forename: Andrea
authors.initials: A
authors.lastname: Talacchi
authors.forename: Mario
authors.initials: M
authors.lastname: Ermani
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001254:Astrocytoma / Q000188:drug therapy* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000188:drug therapy* / Q000532:radiotherapy; D011344:Procarbazine / Q000008:administration & dosage; D012008:Recurrence; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine