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Treatment
> Mitoxantrone
/ Temozolomide
Clinical Trials
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Journal of Neuro-Oncology, Volume 75, Number 2, November, 2005, Pages 215-220,
DOI: 10.1007/s11060-005-3030-x, Online Date November 11, 2005
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Abstract |
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Systemic Temozolomide Combined with
Loco-regional Mitoxantrone in Treating Recurrent Glioblastoma A. Boiardi1*,
M. Eoli1, A. Salmaggi1, E. Lamperti1,
A. Botturi1, G. Broggi2,
L. Bissola3, G. Finocchiaro3
and A. Silvani1
(1)
Department of Neuro-Oncology, Istituto Nazionale Neurologico “Carlo
Besta”, Italy. (2) Department of Neurosurgery, Istituto Nazionale
Neurologico “Carlo Besta”, Italy. (3) Unit of Experimental Neuro-Oncology
and Gene Therapy, Istituto Nazionale Neurologico “Carlo Besta”,
Milano, Italy. -- *Correspondence: A. Boiardi, Email: boiardi@istituto-besta.it
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Twenty-two recurrent GBM patients were
enrolled for second tumor debulking with local positioning of a Rickam
reservoir, in order to locally deliver chemotherapy with the aim of
controlling local tumor recurrence.
We designed a protocol using systemic
temozolomide (150 mg/sqm days 1–5 every 28) in association with
mitoxantrone, delivered through the reservoir (4 mg/day 1–5
every 28) positioned into the area of tumor exeresis.
After re-operation a residual tumor mass
no larger than 2 cm was identified in 18/22 patients.
The patients were treated with monthly
cycles of chemotherapy until evolution of the tumor, but in no case
for more than 10 cycles.
Responses were evaluated by MRI scans
performed every 2 months and images assessed according to
MacDonald’s criteria.
Response rate: no complete responses (CR),
5 partial responses (PR), 13 stable disease (SD) and 4 progressive
disease (PD) occurred.
The median progression-free survival (PFS)
and survival time (ST) of the whole group of treated patients was 7
and 11 months, respectively and more than a quarter of the
patients survived over 18 months.
During the study, the patients’
compliance was complete and no dropouts occurred.
Hematological toxicity was mild and after
repeated local injections only minor neurological side-effects
occurred.
Despite some bias in patients’ selection
not excluded in this pilot study, results are interesting: the PFS was
as long as the survival of recurrent GBM reported in the literature.
Keywords: loco-regional
chemotherapy, mitoxantrone; recurrent glioblastoma; Rickam
reservoir; temozolomide
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©
Springer
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Abstract
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