Concurrent chemoradiotherapy with weekly paclitaxel in malignant cerebral glioma treatment.
BACKGROUND
Anaplastic astrocytomas (AA) and glioblastomas (GB) are the most common malignant gliomas, and despite newly developed drugs and combined treatments, they still have an adverse prognosis. Paclitaxel is a cytotoxic agent with radiosensitizing properties and exerts objective growth inhibition in glioma tumor cells.


METHODS
From 1998 to 2002, 61 microneurosurgically treated patients were randomized to group I (18 GB, 14 AA) which received radiotherapy and weekly paclitaxel at dose of 100 mg/m(2), and group II (21 GB, 8 AA) which received only radiotherapy as a complementary treatment.


RESULTS
Median overall survival was 27.96 months in group I and 23.06 months in group II with no statistical difference. The 12-month survival was 81% in group I and 76% in group II. Kaplan-Meier curves of both groups did not demonstrate any difference. Analysis of each histological subgroup (AA or GB) also showed no statistical difference in the survival curves. All 427 cycles were well tolerated with no treatment-associated deaths.


CONCLUSIONS
Chemoradiotherapy with weekly paclitaxel is safe and tolerable although there was no increase in the overall survival and 12-month survival of malignant glioma patients. Further investigations modulating the paclitaxel entrance and delivery into the brain should be encouraged.
Montemor
José Paulo
JP
Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, RADIUM Institute of Radiotherapy, Campinas, Brazil.
Peria
Fernanda Maris
FM
Monti
Carlos Roberto
CR
Petrilli
Luis Salvador
LS
Colli
Benedicto Oscar
BO
Carlotti Júnior
Carlos Gilberto
CG
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D017239:Paclitaxel / Q000008:administration & dosage*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D017239:Paclitaxel