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Concurrent
chemoradiotherapy in chemo- naive operated glioblastoma multiforme: a phase II
study
Bhawana
S Awasthy, Renita Bhamrah, Omana Nair, Rajvir Singh, Goura K Rath, Chitra Sarkar,
Veer S Mehta, Pramod K Julka
All India
Institute of Medical Sciences, New Delhi, India
Purpose.
Amongst all malignant brain tumors, glioblastoma multiforme (GBM) is associated
with the poorest prognosis.
Chemotherapy (CT) has been shown to have a positive impact when added to surgery
and radiotherapy (RT).
The optimal timing of CT is still unknown.
Docetaxel is a potent radio sensitizer and has been shown to be safe when given
as 23 mg/sq m biweekly with radiation in GBM.
We conducted a phase II study to determine the feasibility and efficacy of
conventional External Beam RT (EBRT) and concurrent weekly docetaxel.
Material
and Methods. Thirty-one patients with a histological diagnosis of GBM were
enrolled from February 2000 to Feb 2001.
Total EBRT dose was 66 Gy (200 cGy per fraction), 5 days a week with the field
size reduced to include gross disease with margin only after 50 Gy.
Docetaxel was administered at a dose of 40 mg/sq m weekly on the first treatment
day of each RT week.
Results.
All the patients were evaluable.
Median age was 51 years (range 18 to 70 years).
Median KPS at study entry was 80.
Gross total resection was performed in 42% of patients.
The mean tumor volume was 85 cc.
Twenty-nine patients (94%) completed therapy as per the protocol.
There were no grade 3 or 4 neutropenia, thrombocytopenia or non-hematological
toxicities.
The observed response rate was 52%, with 8 (26%) CR and 8 (26%) PR.
45% demonstrated progressive disease.
Median survival is 64 weeks.
Mature time to event analysis would be presented.
Conclusion.
Concurrent full dose EBRT and weekly docetaxel is feasible in the majority of
GBM patients.
Acute toxicity is acceptable; median survival is comparable to reports in
literature using adjuvant chemotherapy after EBRT.
Large, randomised studies on concurrent chemoradiation are warranted.
© Copyright 2002 American Society of Clinical Oncology
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0016-00_19-002092,00.asp
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