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Myeloablative chemotherapy for recurrent aggressive oligodendroglioma
- Source :
- Neuro-Oncology. 2:114-119
- Publication Year :
- 2000
- Publisher :
- Oxford University Press (OUP), 2000.
-
Abstract
- The objective of this study was to ascertain the duration of tumor control and the toxicities of dose-intense myeloablative chemotherapy for patients with recurrent oligodendrogliomas. Patients with previously irradiated oligodendrogliomas, either pure or mixed, that were contrast enhancing, measurable, and behaving aggressively at recurrence were eligible for this study. Only complete responders or major partial responders (75 % reduction in tumor size) to induction chemotherapy--either intensive-dose procarbazine, lomustine, and vincristine or cisplatin plus etoposide-could receive high-dose thiotepa (300 mg/m2/day for 3 days) followed by hematopoietic reconstitution using either bone marrow or peripheral blood stem cells. Thirty-eight patients began induction chemotherapy and 20 (10 men, 10 women; median age 46 years; median Karnofsky score 80) received high-dose thiotepa. For the high-dose group, the median event-free, progression-free, and overall survival times from recurrence were 17, 20, and 49 months, respectively. Tumor control in excess of 2 years was observed in 6 patients (30%). Four patients (20%) are alive and tumor free 27 to 77 months (median, 42 months) from the start of induction therapy; however, fatal treatment-related toxicities also occurred in 4 patients (20%). Three patients died as a result of a progressive encephalopathy which, in 2 instances, was accompanied by a wasting syndrome; 1 patient died as a consequence of an intracerebral (intratumoral) hemorrhage. Fatal toxicities occurred in patients with pretreatment Karnofsky scores of 60 or 70. High-dose thiotepa to consolidate response was a disappointing treatment strategy for patients with recurrent aggressive oligodendroglial neoplasms, although several patients had durable responses. Moreover, as prescribed, high-dose thiotepa had significant toxic effects in previously irradiated patients, especially those with poorer performance status.
- Subjects :
- Adult
Male
Cancer Research
medicine.medical_specialty
Cachexia
medicine.medical_treatment
Oligodendroglioma
Hematopoietic stem cell transplantation
ThioTEPA
Procarbazine
Gastroenterology
Disease-Free Survival
Lomustine
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Humans
Medicine
Treatment Failure
Karnofsky Performance Status
Bone Marrow Diseases
Survival rate
Bone Marrow Transplantation
Cerebral Hemorrhage
Etoposide
Brain Diseases
Performance status
Brain Neoplasms
business.industry
Hematopoietic Stem Cell Transplantation
Induction chemotherapy
Middle Aged
Survival Analysis
Chemotherapy regimen
Surgery
Survival Rate
Oncology
Vincristine
Disease Progression
Female
Neurology (clinical)
Cisplatin
Neoplasm Recurrence, Local
business
Thiotepa
Research Article
medicine.drug
Subjects
Details
- ISSN :
- 15235866 and 15228517
- Volume :
- 2
- Database :
- OpenAIRE
- Journal :
- Neuro-Oncology
- Accession number :
- edsair.doi.dedup.....22f001e06de908744e026f33e672bd28