PURPOSE: Feasibility, antitumor activity and toxicity of accelerated hyperfractionated radiation therapy (Acc Hfx RT) and concurrent carboplatin/etoposide (CBDCA/VP 16) chemotherapy were investigated in patients with malignant glioma. MATERIAL AND METHODS: Seventy-nine patients with either glioblastoma multiforme (GBM) (n = 61) or anaplastic astrocytome (AA) (n = 18) entered into a phase II study on the use of Acc Hfx RT with 60 Gy in 40 fractions in 20 treatment days over 4 weeks and concurrent CBDCA, 200 mg/m2, and VP 16, 200 mg/m2, both given once weekly during the RT course. RESULTS: The median survival time for all 79 patients was 14 months (11 and 44 months for GBM and AA patients, respectively), while the 2- and 4-year survival was respectively 33% and 11% for all patients, 13% and 1.6% for GBM patients, and 100% and 44% for AA patients (p < 0.0001). The median time to progression for all patients was 12 months (9 and 40 months for GBM and AA, respectively), while the 2- and 4-year progression-free survival (PFS) was respectively 28% and 10% (all patients), 10% and 1.7% (GBM) and 89% and 39% (AA) (p < 0.0001). Multivariate analysis showed that age, performance status, and preoperative size of tumor influenced survival in GBM. Only 5 (6%) patients experienced grade 3 leukopenia and 6 (8%) patients experienced grade 3 thrombocytopenia. No late RT-induced toxicity was observed to date. CONCLUSIONS: Although Acc Hfx RT/CBDCA + VP 16 was feasible and little toxic, it failed to improve survival/progression-free survival over that obtained with other currently used regimens. These results do not justify the investigation of this regimen in a phase III trial.
PURPOSE: Feasibility, antitumor activity and toxicity of accelerated hyperfractionated radiation therapy (Acc Hfx RT) and concurrent carboplatin/etoposide (CBDCA/VP 16) chemotherapy were investigated in patients with malignant glioma. MATERIAL AND METHODS: Seventy-nine patients with either glioblastoma multiforme (GBM) (n = 61) or anaplastic astrocytome (AA) (n = 18) entered into a phase II study on the use of Acc Hfx RT with 60 Gy in 40 fractions in 20 treatment days over 4 weeks and concurrent CBDCA, 200 mg/m2, and VP 16, 200 mg/m2, both given once weekly during the RT course. RESULTS: The median survival time for all 79 patients was 14 months (11 and 44 months for GBM and AA patients, respectively), while the 2- and 4-year survival was respectively 33% and 11% for all patients, 13% and 1.6% for GBM patients, and 100% and 44% for AA patients (p < 0.0001). The median time to progression for all patients was 12 months (9 and 40 months for GBM and AA, respectively), while the 2- and 4-year progression-free survival (PFS) was respectively 28% and 10% (all patients), 10% and 1.7% (GBM) and 89% and 39% (AA) (p < 0.0001). Multivariate analysis showed that age, performance status, and preoperative size of tumor influenced survival in GBM. Only 5 (6%) patients experienced grade 3 leukopenia and 6 (8%) patients experienced grade 3 thrombocytopenia. No late RT-induced toxicity was observed to date. CONCLUSIONS: Although Acc Hfx RT/CBDCA + VP 16 was feasible and little toxic, it failed to improve survival/progression-free survival over that obtained with other currently used regimens. These results do not justify the investigation of this regimen in a phase III trial.
Authors: D G González; J Menten; D A Bosch; E van der Schueren; D Troost; M C Hulshof; J Bernier Journal: Radiother Oncol Date: 1994-08 Impact factor: 6.280
Authors: M Deutsch; S B Green; T A Strike; P C Burger; J T Robertson; R G Selker; W R Shapiro; J Mealey; J Ransohoff; P Paoletti Journal: Int J Radiat Oncol Biol Phys Date: 1989-06 Impact factor: 7.038
Authors: D F Nelson; M Diener-West; A S Weinstein; D Schoenfeld; J S Nelson; W T Sause; C H Chang; R Goodman; S Carabell Journal: Int J Radiat Oncol Biol Phys Date: 1986-10 Impact factor: 7.038
Authors: U Tirelli; M D'Incalci; R Canetta; S Tumolo; G Franchin; A Veronesi; E Galligioni; M G Trovò; C Rossi; E Grigoletto Journal: J Clin Oncol Date: 1984-05 Impact factor: 44.544
Authors: M P Mehta; J Masciopinto; J Rozental; A Levin; R Chappell; K Bastin; J Miles; P Turski; S Kubsad; T Mackie Journal: Int J Radiat Oncol Biol Phys Date: 1994-10-15 Impact factor: 7.038
Authors: S B Green; D P Byar; M D Walker; D A Pistenmaa; E Alexander; U Batzdorf; W H Brooks; W E Hunt; J Mealey; G L Odom; P Paoletti; J Ransohoff; J T Robertson; R G Selker; W R Shapiro; K R Smith; C B Wilson; T A Strike Journal: Cancer Treat Rep Date: 1983-02