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PCV and/or TMZ
chemotherapy in 255 gliomas. Analysis of the clinical experience from a
neuro-oncology data-base
A. Pace, A. Pompili, M. Maschio, E. Galie', S. Telera, B. Jandolo, E.
Occhipinti, C. M. Carapella
Regina Elena Nat. Cancer Inst., Rome, Italy
Background.
The role of chemotherapy (CT) in the treatment of malignant
gliomas is still debated.
Different chemotherapeutic agents are currently used with modest impact on
survival.
At the moment there are no clear-cut data indicating more effective or
better-tolerated treatments.
Furthermore the evaluation of response to CT should include also clinical
benefit and quality of life.
Methods.
We retrospectively analyzed our experience in chemotherapy of
malignant gliomas with the aim of evaluating time to tumor progression, clinical
benefit, quality of life (EORTC QLQ-C30), and toxicity.
Results.
255 recurrent malignant glioma patients were treated with
chemotherapy (PCV or Temozolomide) in our Institution since 1997.
Histology was: Glioblastoma (GB) in 123; Anaplastic astrocytoma (AA) 56; Mixed
Anaplastic Oligo-Astrocytoma (AO) 43; Progressive Low Grade Astrocytoma (LGA)
42; Anaplastic Oligos (O) 28.
The overall response rate (RR) by histology was: CR+PR in GB 7.4%; AA 26.8%; AO
51.6%; LGA 48.4%; O 44.4%.
Treatment schedule was PCV in 193 patients and Temozolomide (TMZ) standard
schedule in 129.
RR was not significant different for the two treatments.
69 patients received two line of chemotherapy (44 first line PCV and 25 first
line TMZ).
In the present series, tumors which respond at first line CT are more likely to
respond to second line treatment.
In 13.5% patients treated with PCV the treatment was interrupted for
toxicity.
During TMZ treatment 10.9% of patients presented myelotoxicity grade 3-4 (WHO),
leading to treatment interruption in 4.6% of cases.
Conclusions.
Considering the modest influence of CT on overall survival
in malignant gliomas, less toxic drugs should be preferred for first line
treatment.
Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0026-00_19-003816,00.asp
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