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Carboplatin and etoposide for recurrent malignant glioma following surgical and radiotherapy failure: A clinical study conducted at the Northern Israel Oncology Center
Author(s) -
Stein Moshe E.,
Kuten Abraham,
Drumea Karen,
Goldsher Dorith,
TzukShina Zahala
Publication year - 1999
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199907)71:3<167::aid-jso6>3.0.co;2-v
Subject(s) - medicine , carboplatin , etoposide , glioma , chemotherapy , regimen , progressive disease , surgery , radiation therapy , chemotherapy regimen , neutropenia , performance status , phases of clinical research , cisplatin , cancer research
Background and Objectives We conducted a phase II study using carboplatin and etoposide on patients with recurrent malignant glioma to investigate tumor response. Methods From January 1995 to March 1997, 21 patients with recurrent malignant glioma were treated with a carboplatin (300 mg/m 2 , day 1)/etoposide (100 mg/m 2 , days 1–3) regimen every 3–4 weeks. The following radiologic parameters were evaluated: tumor size, central lucency, degree of contrast enhancement, and mass effect. No patient had received chemotherapy previously. Dose escalation corresponded to hematologic tolerance and to general and neurologic performance status. Most patients were treated postoperatively with involved field radiotherapy followed by a boost to the tumor area, as defined on the presurgery computed tomography scan or on magnetic resonance imaging. Mean interval to introduction of chemotherapy was 8.8 months (range, 7–36 months). Patients received a mean of four cycles [range, 2–8 cycles]. Results Only 2 patients showed moderate radiological response, while 12 patients died of progressive disease. Mean time to progression following discontinuation of chemotherapy was 5.8 months (range, 1–11 months). The other patients survived with persistent disease and are being treated palliatively. Toxicity was manageable (1, neutropenic sepsis; 1, thrombocytopenia (45,000/mm 3 ); 2, temporarily elevated transaminase level; 2, steroid‐induced erosive gastritis). Conclusions This phase II regimen proved to be ineffective in recurrent malignant glioma. Further studies incorporating innovative drug regimens and schedules are warranted. J. Surg. Oncol., 1999;71:167–170. © 1999 Wiley‐Liss, Inc.