Second-line chemotherapy with dacarbazine and fotemustine in nitrosourea-pretreated patients with recurrent glioblastoma multiforme

被引:31
|
作者
Fazeny-Dörner, B
Veitl, M
Wenzel, C
Piribauer, M
Rössler, K
Dieckmann, K
Ungersböck, K
Marosi, C
机构
[1] Univ Vienna, Div Clin Oncol, Vienna, Austria
[2] Univ Vienna, Ludwig Boltzmann Inst Clin Expt Oncol, Dept Med 1, Vienna, Austria
[3] Univ Vienna, Inst Clin Med, Vienna, Austria
[4] Univ Vienna, Chem Lab Diagnost, Vienna, Austria
[5] Univ Vienna, Dept Neurosurg, Vienna, Austria
[6] Univ Vienna, Dept Radiooncol, Vienna, Austria
关键词
chemotherapy; dacarbazine; fotemustine; glioblastoma; nitrosourea pretreatment; recurrent gliomas; survival;
D O I
10.1097/01.cad.0000078734.65608.f6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The aim of this study was to assess the efficacy and toxicity of a combination of dacarbazine (D) and fotemustine (F) administered to a homogenous group of patients with recurrent or progressive glioblastoma multiforme (GBM). Thirty-one patients with computed tomography or magnetic resonance imaging scan evidence of recurrent or progressive GBM after first-line chemotherapy with nitrosoureas as well as radiation therapy were given a combination of D (200 mg/m(2)) and F (100 mg/m(2)). At 30 min after termination of D administration, F was given over 60 min. Treatment was performed in an outpatient setting every 21 days. A total of 140 cycles (range 1-12 cycles; median 4 cycles) was administered. One partial response (3%) lasting for 11 weeks was observed. Sixteen (52%) patients reached stable disease lasting between 7 and 94 weeks. Median survival from start of the D/F combination was 45 (range 10-150) weeks. Median time to progression was 17 (3-101) weeks for all patients. Major toxicity was myelosuppression resulting in exclusion from study in seven (23%) patients [due to thrombocytopenia common toxicity criteria (CTC) grade 2 persisting longer than 3 weeks in three patients, due to thrombocytopenia CTC grade greater than or equal to 3 in three and due to leukopenia CTC grade 3 in one patient]. No other toxicity than alopecia occurred. We conclude that the D/F combination is a well-tolerated second-line regimen and can be administered in a complete outpatient setting. D/F shows efficacy even in nitrosourea-pretreated patients and justifies further investigation.
引用
收藏
页码:437 / 442
页数:6
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