title: Efficacy of monoterpene perillyl alcohol upon survival rate of patients with recurrent glioblastoma.
abstract: OBJECTIVE
  The monoterpene perillyl alcohol (POH) a Ras inhibitor with potential capacity to arrest gliomagenesis is being used in a phase I/II clinical trial in adults with recurrent malignant glioma. The present study aimed to investigate the efficacy of intranasal administration of monoterpene POH upon survival rate of patients with recurrent glioblastoma (GBM) in comparison with historical control group of GBM patients.
  
  
  METHODS
  It was included 89 adults with recurrent GBM receiving daily intranasal administration of 440 mg POH and 52 matched GBM patients as historical control untreated group only with supportive treatment.
  
  
  RESULTS
  Patients with recurrent primary GBM treated with POH survived significantly longer (log rank test, P < 0.0001) than untreated group. Patients with recurrent primary GBM in deep location survived significantly longer than with lobar location (log rank test, P < 0.0001). Median survival rate of secondary GBM was 11.2 months, longer (log rank test, P = 0.0366) than primary GBM (5.9 months). Radiographic improvement and reduction of corticosteroid dosage (36%) further associated with a delay towards progression.
  
  
  CONCLUSIONS
  Intranasal administration of POH increased the overall survival of patients with recurrent GBM in comparison with historical untreated controls, but especially patients with secondary GBM and primary GBM with tumor localized in deep regions of the brain. The side effects of POH treatment were almost nonexistent, even in patients treated for over 4 years.
authors.affiliation: Departamento de Cirurgia Geral e Especializada, Unidade de Pesquisa Clínica, Hospital Universitário Antonio Pedro, Niterói, RJ 24030-210, Brazil. clovis.orlando@uol.com.br
authors.forename: Clovis O
authors.initials: CO
authors.lastname: da Fonseca
authors.forename: Marcela
authors.initials: M
authors.lastname: Simão
authors.forename: Igor R
authors.initials: IR
authors.lastname: Lins
authors.forename: Regina O
authors.initials: RO
authors.lastname: Caetano
authors.forename: Débora
authors.initials: D
authors.lastname: Futuro
authors.forename: Thereza
authors.initials: T
authors.lastname: Quirico-Santos
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D039821:Monoterpenes / Q000008:administration & dosage / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D018579:Patient Selection
chemical_list: D000970:Antineoplastic Agents; D039821:Monoterpenes; C032208:perillyl alcohol
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