Efficacy and safety of second-line fotemustine in elderly patients with recurrent glioblastoma

被引:10
|
作者
Santoni, Matteo [1 ]
Scoccianti, Silvia [2 ]
Lolli, Ivan [3 ]
Fabrini, Maria Grazia [4 ]
Silvano, Giovanni [5 ]
Detti, Beatrice [2 ]
Perrone, Franco [4 ]
Savio, Giuseppina [6 ]
Iacovelli, Roberto [7 ]
Burattini, Luciano [1 ]
Berardi, Rossana [1 ]
Cascinu, Stefano [1 ]
机构
[1] Univ Politecn Marche, Clin Oncol Med, AOU Osped Riuniti, I-60100 Ancona, Italy
[2] Azienda Osped Univ Careggi, Florence, Italy
[3] IRCCS Saverio de Bellis, I-70013 Bari, Italy
[4] Azienda Osped Univ Pisana, Pisa, Italy
[5] Radioterapia Oncol SG Moscati Hosp, Taranto, Italy
[6] UO Oncol Med ARNAS Civ, Palermo, Italy
[7] Univ Roma La Sapienza, Dipartimento Sci Radiol Oncol & Anatomopatol, I-00185 Rome, Italy
关键词
Elderly patients; Fotemustine; Glioblastoma; Safety; Temozolomide; PHASE-II; HYPOFRACTIONATED RADIOTHERAPY; ADJUVANT TEMOZOLOMIDE; MALIGNANT GLIOMA; CONCOMITANT; CHEMOTHERAPY; SURVIVAL;
D O I
10.1007/s11060-013-1125-3
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Fotemustine (FTM) is a common treatment option for glioblastoma patients refractory to temozolomide (TMZ). Although elderly patients represent a large component of glioblastoma population, the feasibility and the efficacy of second-line FTM are not available in those patients.We retrospectively analyzed the records of glioblastoma patients older than 65 years, receiving FTM at a dose of 70-100 mg/m(2) of FTM every week for 3 consecutive weeks (induction phase) and then every 3 weeks (70-100 mg/m(2)), as second-line treatment.Between January 2004 and December 2011, 65 glioblastoma patients (median age, 70 years; range, 65-79 years) were eligible for this analysis. Sixty-five patients received a total of 364 FTM cycles, with a median of 4 cycles for each patient. After induction, we observed 1 complete response (1.5 %), 12 partial responses (18.5 %), 18 stable diseases (27.7 %), and 34 patients' progressions (47.7 %). Disease control rate was 43.1 %. Median survival from the beginning of FTM therapy was 7.1 months, while the median progression-free survival was 4.2 months, and the 6-months progression free survival rate was 35.4 %. The most relevant grade 3-4 toxicity events were thrombocytopenia (15.3 %) and neutropenia (9.2 %). In the univariate and multivariate analysis, time from radiotherapy to FTM, number of TMZ and FTM cycles and disease control resulted independent prognostic factors.This study showed that FTM is a valuable therapeutic option for elderly glioblastoma patients, with a safe toxicity profile.
引用
收藏
页码:397 / 401
页数:5
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