AIM: To evaluate the possibility of implementing a new scheme of rescue treatment after relapse or progression of high-grade glioma (HGG) treated at the first-line with bevacizumab and irinotecan (BVZ+CPT11), evaluating the response and toxicity of associating BVZ and fractionated stereotactic radiotherapy (BVZ+FSRT). MATERIALS AND METHODS: We retrospectively analysed data from 59 patients with relapse of HGG. Nine patients with HGG relapse after treatment using the Stupp protocol that were treated with BVZ+CPT11 for progression between July 2007 and August 2012, after which the response was assessed according to the Revised Assessment in Neuro-Oncology (RANO) criteria. BVZ was administered at a dose of 10 mg/kg and FSRT up to a prescribed dose of 30 Gy, 500 cGy per fraction, three days a week. The median follow-up was 38 months. RESULTS: The treatment was well-tolerated by all patients. The response after nuclear magnetic resonance imaging (MRI) at 3-6 months was progression in two patients, stable disease in four, and three patients had a partial response. The median overall survival (OS) from diagnosis until death or the last control was 36.8 months. The median progression-free survival (PFS) was 10.8 months. The results from tumour sub-group analysis indicated that the PFS was not statistically significant although it seemed that it was higher in grade-III. The OS was higher in grade-III gliomas. CONCLUSIONS: The combination of BVZ+FSRT as a second-line HGG relapse rescue treatment is well-tolerated and seems to offer promising results. We believe that multi-centre prospective studies are needed to determine the long-term efficacy and toxicity of this therapeutic approach.
AIM: To evaluate the possibility of implementing a new scheme of rescue treatment after relapse or progression of high-grade glioma (HGG) treated at the first-line with bevacizumab and irinotecan (BVZ+CPT11), evaluating the response and toxicity of associating BVZ and fractionated stereotactic radiotherapy (BVZ+FSRT). MATERIALS AND METHODS: We retrospectively analysed data from 59 patients with relapse of HGG. Nine patients with HGG relapse after treatment using the Stupp protocol that were treated with BVZ+CPT11 for progression between July 2007 and August 2012, after which the response was assessed according to the Revised Assessment in Neuro-Oncology (RANO) criteria. BVZ was administered at a dose of 10 mg/kg and FSRT up to a prescribed dose of 30 Gy, 500 cGy per fraction, three days a week. The median follow-up was 38 months. RESULTS: The treatment was well-tolerated by all patients. The response after nuclear magnetic resonance imaging (MRI) at 3-6 months was progression in two patients, stable disease in four, and three patients had a partial response. The median overall survival (OS) from diagnosis until death or the last control was 36.8 months. The median progression-free survival (PFS) was 10.8 months. The results from tumour sub-group analysis indicated that the PFS was not statistically significant although it seemed that it was higher in grade-III. The OS was higher in grade-III gliomas. CONCLUSIONS: The combination of BVZ+FSRT as a second-line HGG relapse rescue treatment is well-tolerated and seems to offer promising results. We believe that multi-centre prospective studies are needed to determine the long-term efficacy and toxicity of this therapeutic approach.
Authors: John K Park; Tiffany Hodges; Leopold Arko; Michael Shen; Donna Dello Iacono; Adrian McNabb; Nancy Olsen Bailey; Teri Nguyen Kreisl; Fabio M Iwamoto; Joohee Sul; Sungyoung Auh; Grace E Park; Howard A Fine; Peter McL Black Journal: J Clin Oncol Date: 2010-07-19 Impact factor: 44.544
Authors: Samuel T Chao; Manmeet S Ahluwalia; Gene H Barnett; Glen H J Stevens; Erin S Murphy; Abigail L Stockham; Kevin Shiue; John H Suh Journal: Int J Radiat Oncol Biol Phys Date: 2013-06-19 Impact factor: 7.038
Authors: O L Chinot; T de La Motte Rouge; N Moore; A Zeaiter; A Das; H Phillips; Z Modrusan; T Cloughesy Journal: Adv Ther Date: 2011-03-14 Impact factor: 3.845
Authors: Roger Stupp; Monika E Hegi; Warren P Mason; Martin J van den Bent; Martin J B Taphoorn; Robert C Janzer; Samuel K Ludwin; Anouk Allgeier; Barbara Fisher; Karl Belanger; Peter Hau; Alba A Brandes; Johanna Gijtenbeek; Christine Marosi; Charles J Vecht; Karima Mokhtari; Pieter Wesseling; Salvador Villa; Elizabeth Eisenhauer; Thierry Gorlia; Michael Weller; Denis Lacombe; J Gregory Cairncross; René-Olivier Mirimanoff Journal: Lancet Oncol Date: 2009-03-09 Impact factor: 41.316
Authors: Dietmar Krex; Barbara Klink; Christian Hartmann; Andreas von Deimling; Torsten Pietsch; Matthias Simon; Michael Sabel; Joachim P Steinbach; Oliver Heese; Guido Reifenberger; Michael Weller; Gabriele Schackert Journal: Brain Date: 2007-09-04 Impact factor: 13.501
Authors: Arnold C Paulino; Wei Y Mai; Murali Chintagumpala; Abida Taher; Bin S Teh Journal: Int J Radiat Oncol Biol Phys Date: 2008-02-11 Impact factor: 7.038
Authors: Philip H Gutin; Fabio M Iwamoto; Kathryn Beal; Nimish A Mohile; Sasan Karimi; Bob L Hou; Stella Lymberis; Yoshiya Yamada; Jenghwa Chang; Lauren E Abrey Journal: Int J Radiat Oncol Biol Phys Date: 2009-01-23 Impact factor: 7.038