title: Low-dose fotemustine as second-line chemotherapy for recurrent glioblastoma multiforme.
abstract: OBJECTIVE
  To test if fotemustine administrated at low doses during the maintenance phase of gioblastoma therapy could improve the toxicity profile, without reducing progression-free survival at six months (PFS-6).
  
  
  METHODS
  Patients enrolled were affected by recurrent glioblastoma multiforme, proven by magnetic resonance imaging (MRI), at least six months after radiochemotherapy completion. Fotemustine was administered at an induction dose of 100 mg/m(2) followed by a maintenance dose of 75 mg/m(2).
  
  
  RESULTS
  All 15 patients completed the induction phase. Eight patients began maintenance-phase therapy and received a median of three cycles (range=2-6). Grade 3 or more haematological toxicity was not documented. The PFS-6 was 5/15 and the median overall survival was 7.5 months.
  
  
  CONCLUSIONS
  Haematological toxicity compares favourably with trials using the conventional scheme: no grade 3-4 adverse effects were recorded. This low-dose approach could be considered a compromise treatment whilst waiting for definitive standardization of second-line therapy, in order to reduce severe hematological toxicity.
authors.affiliation: Viale Regina Elena 155, 00161 Rome, Italy. brency7@hotmail.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: De Felice
authors.forename: Nadia
authors.initials: N
authors.lastname: Bulzonetti
authors.forename: Daniela
authors.initials: D
authors.lastname: Musio
authors.forename: Alessandro
authors.initials: A
authors.lastname: D'Elia
authors.forename: Maurizio
authors.initials: M
authors.lastname: Salvati
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tombolini
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009607:Nitrosourea Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence
chemical_list: D000970:Antineoplastic Agents; D009607:Nitrosourea Compounds; D009943:Organophosphorus Compounds; C054368:fotemustine
keywords: Fotemustine; chemotherapy; glioblastoma; low-dose; second-line therapy