title: The combination of carmustine wafers and fotemustine in recurrent glioblastoma patients: a monoinstitutional experience.
abstract: BACKGROUND
  To date, there is no standard treatment for recurrent glioblastoma. We analyzed the feasibility of second surgery plus carmustine wafers followed by intravenous fotemustine.
  
  
  METHODS
  Retrospectively, we analyzed patients with recurrent glioblastoma treated with this multimodal strategy.
  
  
  RESULTS
  Twenty-four patients were analyzed. The median age was 53.6; all patients had KPS between 90 and 100; 19 patients (79%) performed a gross total resection > 98% and 5 (21%) a gross total resection > 90%. The median progression-free survival from second surgery was 6 months (95% CI 3.9-8.05) and the median OS was 14 months (95% CI 11.1-16.8 months). Toxicity was predominantly haematological: 5 patients (21%) experienced grade 3-4 thrombocytopenia and 3 patients (12%) grade 3-4 leukopenia.
  
  
  CONCLUSIONS
  This multimodal strategy may be feasible in patients with recurrent glioblastoma, in particular, for patients in good clinical conditions.
authors.affiliation: Medical Oncology 1 Unit, Venetian Oncology Institute-IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lombardi
authors.affiliation: Neurosurgery Department, Azienda Ospedaliera di Padova, 35128 Padua, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Della Puppa
authors.affiliation: Medical Oncology 1 Unit, Venetian Oncology Institute-IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
authors.forename: Fable
authors.initials: F
authors.lastname: Zustovich
authors.affiliation: Medical Oncology 1 Unit, Venetian Oncology Institute-IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
authors.forename: Ardi
authors.initials: A
authors.lastname: Pambuku
authors.affiliation: Medical Oncology 1 Unit, Venetian Oncology Institute-IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Farina
authors.affiliation: Clinical Trials and Biostatistics Unit, Venetian Oncology Institute-IRCCS, 35128 Padua, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Fiduccia
authors.affiliation: Medical Oncology 1 Unit, Venetian Oncology Institute-IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Roma
authors.affiliation: Medical Oncology 1 Unit, Venetian Oncology Institute-IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
authors.forename: Vittorina
authors.initials: V
authors.lastname: Zagonel
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D002330:Carmustine / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009607:Nitrosourea Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D009607:Nitrosourea Compounds; D009943:Organophosphorus Compounds; C054368:fotemustine; D002330:Carmustine