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Second-line treatment with carboplatin for
recurrent or progressive oligodendroglial tumors after PCV (procarbazine,
lomustine, and vincristine) chemotherapy: a phase II study
Soffietti R, Nobile M, Ruda R, Borgognone M, Costanza A, Laguzzi E, Mutani R
Neuro-Oncology Service, Department of Neuroscience, San Giovanni
Battista Hospital, University of Turin, Turin, Italy.
riccardo.soffietti@unito.it
Background.
The efficacy of second-line chemotherapy for patients with
recurrent or progressive oligodendroglial tumors is limited.
In the current study, the authors investigated the use of carboplatin as a
second-line chemotherapeutic agent against these types of tumors.
Methods. Twenty-three patients with recurrent or progressive
oligodendrogliomas or oligoastrocytomas after first-line PCV (procarbazine,
lomustine, and vincristine) chemotherapy were enrolled in a single-institution
Phase II study of second-line carboplatin chemotherapy.
All patients had undergone surgery, and most also had undergone conventional
radiotherapy.
Carboplatin was administered at a dose of 560 mg/m2 intravenously every 4
weeks.
Responses were evaluated according to conventional criteria, based on magnetic
resonance imaging (MRI) findings.
Results. Three of 23 patients (13%) had partial responses, with
neurologic improvement.
Twelve patients (52%) had stable disease; in 2 of these 12 patients, a minor
response was seen on MRI.
Eight patients (35%) had progressive disease.
The median time to tumor progression was 3 months for all patients and 9 months
for patients who experienced responses to treatment.
Progression-free survival rates at 6 and 12 months were 34.8% and 8.7%,
respectively.
Among the salvage treatment plans followed after carboplatin chemotherapy were
supportive care alone, radiotherapy, third-line chemotherapy, and
reoperation.
The median survival duration from the start of carboplatin administration was 16
months.
Myelotoxicity was severe, with Grade 3 or 4 thrombocytopenia in 60% of patients
and Grade 3 or 4 neutropenia in 48% of patients.
Conclusions. When administered according to a monthly schedule,
carboplatin exhibited modest activity in adult patients with recurrent or
progressive oligodendroglioma or oligoastrocytoma who experienced treatment
failure after PCV chemotherapy; the current treatment regimen also was
associated with severe toxicity.
Further improvement of second-line chemotherapy for the patient group examined
in the current study is necessary.
Copyright 2004 American Cancer Society.
PMID: 14770438 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14770438
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