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Radiotherapy and
concomitant weekly carboplatin and daily etoposide for patients with inoperable
biopsy proven glioblastoma multiforme
J. M. Simon, G. Noel, K. Hoang-Xuan, A. F. Carpentier, K. Mokhtari, S.
Racadot, F. Baillet, J. J. Mazeron
Pitie-Salpetriere Hospital, AP-HP, Paris, France
Background.
This study was performed to evaluate the toxicity and
efficacy of concomitant carboplatin and etoposide with external beam
radiotherapy in the management of inoperable glioblastoma.
Methods.
From 8/99 to 10/01, 26 consecutive patients with inoperable
biopsy proven glioblastoma were treated with radiotherapy (59.4 Gy in 1.8
Gy/fraction), weekly carboplatin (area under curve = 1.5), and etoposide (given
daily as a single oral dose of 50 mg, 1 hour before each treatment
session).
Informed consent was obtained from all patients.
This experimental group was compared to an historical group of 24
patients with inoperable biopsy proven glioblastoma treated with definitive
radiotherapy in our institution.
Acute toxicity was graded according to World Heath Organization criteria
and scored weekly during treatment and within 2 months after the end of
therapy.
The primary endpoint of this study was overall survival.
Results.
The two groups of patients were matched for sex ratio, age
(median: 55 years [range, 31 to 69 years] and 56 years [range, 40 to 69 years],
for the experimental and control groups respectively), tumor location, tumor
extension, Karnofsky performance status (median: 80 [range, 60 to 100] and 90
[range, 60 to 100], for the experimental and control groups respectively), and
the RTOG recursive partitioning analysis (RPA) classes.
The median follow-up was sixty-eight weeks.
Median survival times were 40 and 36 weeks, and the 1-year overall
survival rates were 46% and 4%, respectively for patients treated with
carboplatin and etoposide, and for those treated in the control group (p <
0.02).
Carboplatin and etoposide were well tolerated.
The incidence of grade 3 and 4 hematological toxicity related to
chemotherapy was 12% in the experimental group.
Conclusions.
Concomitant radiation plus weekly carboplatin and daily
etoposide was safe and well tolerable.
This regimen seemed to increase overall survival in patients with
unresectable glioblastoma.
A larger randomized trial is warranted to confirm these results.
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_19-003735,00.asp
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