title: Long-term outcome in patients with recurrent malignant glioma treated with Perillyl alcohol inhalation.
abstract: OBJECTIVE
  This retrospective study aimed to evaluate the long-term response and toxicity of recurrent malignant glioma patients to inhalation chemotherapy with perillyl alcohol (POH).
  
  
  METHODS
  The cohort included 117 men and 81 women with primary glioblastoma multiforme (GBM; n=154), grade III astrocytoma (AA; n=26) and anaplastic oligodendroglioma (AO; n=5). POH inhalation schedule 4-times daily started with 66.7 mg/dose; 266 mg/day and escalated up to 133.4 mg/dose; 533.6 mg/day. Clinical toxicity and overall survival following treatment were compared with tumor size, topography, extent of peritumoral edema and histological classification.
  
  
  RESULTS
  Adhesion to the protocol was high (>95%), POH (533.6 mg/daily) occasionally caused nose soreness but rarely nosebleed. Tumor size, peritumoral edema and the oligodendroglial component influenced response to treatment.
  
  
  CONCLUSIONS
  After 4 years under exclusive POH treatment, 19% of patients still remain in clinical remission. Long-term POH inhalation chemotherapy is a safe and non-invasive strategy efficient for recurrent malignant glioma.
authors: Laboratory of Cellular Pathology, Institute of Biology, Fluminense Federal University, Niteroi, RJ, 24020-141, Brazil. tquirico@vm.uff.br.
authors: Clovis O
authors: CO
authors: DA Fonseca
authors: Raphael M
authors: RM
authors: Teixeira
authors: Júlio Cesar T
authors: JC
authors: Silva
authors: Juliana
authors: J
authors: DE Saldanha DA Gama Fischer
authors: Osório C
authors: OC
authors: Meirelles
authors: Jose Alberto
authors: JA
authors: Landeiro
authors: Thereza
authors: T
authors: Quirico-Santos
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy*; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D039821:Monoterpenes / Q000008:administration & dosage* / Q000627:therapeutic use; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D039821:Monoterpenes; C032208:perillyl alcohol
keywords: GBM; Phase II trial; glioblastoma multiforme; glioma; intranasal administration; perillyl alcohol