Advantage of Treating Anaplastic Gliomas with Aggressive Protocol Combining Chemotherapy and Radiotherapy

Overview

Journal J Neurooncol

Publisher Springer

Date 1997 Sep 1

PMID 9210066

Citations 6

Authors

A Boiardi

A Silvani

A Pozzi

M Farinotti

L Fariselli

G Broggi

A Salmaggi

Affiliations

Soon will be listed here.

Abstract

We devised a treatment protocol for anaplastic gliomas consisting of:(a) chemotherapy prior to radiotherapy (b) a second chemotherapy regimen at tumor recurrence (c) repeated surgery whenever possible. 41 Anaplastic Astrocytoma (AA), 16 Anaplastic oligoastrocytoma (AOA) and 14 anaplastic oligodendroglioma (AOD) patients were treated. After surgery all patients received 5-6 cycles of carmustine+Cisplatinum chemotherapy. Radiotherapy was started during the last 2-3 cycles of chemotherapy. 17 patients (30.5%) were reoperated on at recurrence. All recurring patients underwent PVC chemotherapy. At this moment disease recurred in 56 patients. Median TTP was 24.5, 38.7 and 58.2 months for AA, AOA and AOD respectively. Median ST was 38.8, 71.8 and 73 months. In conclusion our sandwich protocol of prior chemotherapy, overlapping irradiation with second chemotherapy and, in favourable cases, a second surgical intervention, is of benefit in patients with anaplastic gliomas.

Citing Articles

Longitudinal microPET imaging of brain tumor growth with F-18-labeled RGD peptide.

Chen X, Park R, Khankaldyyan V, Gonzales-Gomez I, Tohme M, Moats R Mol Imaging Biol. 2005; 8(1):9-15.

PMID: 16315003 DOI: 10.1007/s11307-005-0024-1.

Safety and efficacy of a novel cannabinoid chemotherapeutic, KM-233, for the treatment of high-grade glioma.

Duntsch C, Divi M, Jones T, Zhou Q, Krishnamurthy M, Boehm P J Neurooncol. 2005; 77(2):143-52.

PMID: 16314952 DOI: 10.1007/s11060-005-9031-y.

Oligodendroglioma.

Ellis T, Stieber V, Austin R Curr Treat Options Oncol. 2003; 4(6):479-90.

PMID: 14585228 DOI: 10.1007/s11864-003-0048-1.

The conditional survival statistics for survivors with primary supratentorial astrocytic tumors.

Hwang S, Yang Y, Lieu A, Chuang M, Chang S, Chang Y J Neurooncol. 2001; 50(3):257-64.

PMID: 11263506 DOI: 10.1023/a:1006484220764.

Cisplatin and BCNU chemotherapy for anaplastic oligoastrocytomas.

Boiardi A, Eoli M, Salmaggi A, Pollo B, Milanesi I, Broggi G J Neurooncol. 2000; 49(1):71-5.

PMID: 11131989 DOI: 10.1023/a:1006489919811.

References

WILKINSON I, ANDERSON J, Holmes A . Oligodendroglioma: an analysis of 42 cases. J Neurol Neurosurg Psychiatry. 1987; 50(3):304-12. PMC: 1031795. DOI: 10.1136/jnnp.50.3.304. View

Mork S, Halvorsen T, Lindegaard K, Eide G . Oligodendroglioma. Histologic evaluation and prognosis. J Neuropathol Exp Neurol. 1986; 45(1):65-78. DOI: 10.1097/00005072-198601000-00006. View

Allen J, Helson L, Jereb B . Preradiation chemotherapy for newly diagnosed childhood brain tumors. A modified Phase II trial. Cancer. 1983; 52(11):2001-6. DOI: 10.1002/1097-0142(19831201)52:11<2001::aid-cncr2820521105>3.0.co;2-d. View

Cooper J, Borok T, Ransohoff J, Carella R . Malignant glioma. Results of combined modality therapy. JAMA. 1982; 248(1):62-5. DOI: 10.1001/jama.248.1.62. View

Bullard D, Rawlings 3rd C, Phillips B, Cox E, Schold Jr S, Burger P . Oligodendroglioma. An analysis of the value of radiation therapy. Cancer. 1987; 60(9):2179-88. DOI: 10.1002/1097-0142(19871101)60:9<2179::aid-cncr2820600912>3.0.co;2-g. View

Nelson D, Nelson J, Davis D, Chang C, Griffin T, Pajak T . Survival and prognosis of patients with astrocytoma with atypical or anaplastic features. J Neurooncol. 1985; 3(2):99-103. DOI: 10.1007/BF02228884. View

Pendergrass T, Milstein J, Geyer J, Mulne A, Kosnik E, Morris J . Eight drugs in one day chemotherapy for brain tumors: experience in 107 children and rationale for preradiation chemotherapy. J Clin Oncol. 1987; 5(8):1221-31. DOI: 10.1200/JCO.1987.5.8.1221. View

. Evaluation of CCNU, VM-26 plus CCNU, and procarbazine in supratentorial brain gliomas. Final evaluation of a randomized study. European Organization for Research on Treatment of Cancer (EORTC) Brain Tumor Group. J Neurosurg. 1981; 55(1):27-31. DOI: 10.3171/jns.1981.55.1.0027. View

Winger M, Macdonald D, Cairncross J . Supratentorial anaplastic gliomas in adults. The prognostic importance of extent of resection and prior low-grade glioma. J Neurosurg. 1989; 71(4):487-93. DOI: 10.3171/jns.1989.71.4.0487. View

10.

Zimmerman R . Imaging of adult central nervous system primary malignant gliomas. Staging and follow-up. Cancer. 1991; 67(4 Suppl):1278-83. DOI: 10.1002/1097-0142(19910215)67:4+<1278::aid-cncr2820671526>3.0.co;2-u. View

11.

Ludwig C, Smith M, Godfrey A, Armbrustmacher V . A clinicopathological study of 323 patients with oligodendrogliomas. Ann Neurol. 1986; 19(1):15-21. DOI: 10.1002/ana.410190104. View

12.

Reymond A, RINGERTZ N . [Oligodendroglioma; anatomicoclinical study of 74 cases]. Schweiz Arch Neurol Psychiatr. 1950; 65(1-2):221-54. View

13.

Shaw E, Scheithauer B, OFallon J, Davis D . Mixed oligoastrocytomas: a survival and prognostic factor analysis. Neurosurgery. 1994; 34(4):577-82; discussion 582. DOI: 10.1227/00006123-199404000-00002. View

14.

WISLAWSKI J . Cerebral oligodendrogliomas. Clinical manifestations, surgical treatment and histological findings in seventy cases. Pol Med J. 1970; 9(1):163-72. View

15.

Cairncross J, Macdonald D . Successful chemotherapy for recurrent malignant oligodendroglioma. Ann Neurol. 1988; 23(4):360-4. DOI: 10.1002/ana.410230408. View

16.

Nazzaro J, Neuwelt E . The role of surgery in the management of supratentorial intermediate and high-grade astrocytomas in adults. J Neurosurg. 1990; 73(3):331-44. DOI: 10.3171/jns.1990.73.3.0331. View

17.

Glass J, Hochberg F, Gruber M, Louis D, Smith D, Rattner B . The treatment of oligodendrogliomas and mixed oligodendroglioma-astrocytomas with PCV chemotherapy. J Neurosurg. 1992; 76(5):741-5. DOI: 10.3171/jns.1992.76.5.0741. View

18.

Levin V, Silver P, Hannigan J, Wara W, Gutin P, Davis R . Superiority of post-radiotherapy adjuvant chemotherapy with CCNU, procarbazine, and vincristine (PCV) over BCNU for anaplastic gliomas: NCOG 6G61 final report. Int J Radiat Oncol Biol Phys. 1990; 18(2):321-4. DOI: 10.1016/0360-3016(90)90096-3. View

19.

Ammirati M, Galicich J, Arbit E, Liao Y . Reoperation in the treatment of recurrent intracranial malignant gliomas. Neurosurgery. 1987; 21(5):607-14. DOI: 10.1227/00006123-198711000-00001. View

20.

Leibel S, SHELINE G . Radiation therapy for neoplasms of the brain. J Neurosurg. 1987; 66(1):1-22. DOI: 10.3171/jns.1987.66.1.0001. View