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High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma
- Source :
- Journal of neuro-oncology. 65(2)
- Publication Year :
- 2003
-
Abstract
- Anaplastic oligodendroglioma is a chemosensitive glial neoplasm. To improve disease control and postpone cranial radiotherapy, we designed a phase II study of intensive procarbazine, lomunstine and vincristine followed by high-dose thiotepa with autologous stem cell rescue for patients with newly diagnosed anaplastic or aggressive oligodendroglioma.Sixty-nine patients with a median age of 42 (range: 18-67) and a median Karnofsky Performance Score of 90 (range: 70-100) were enrolled. Sixteen patients had a prior diagnosis of low-grade oligodendroglioma and 16 had mixed oligoastrocytoma pathology. Only patients with demonstrably chemosensitive enhancing tumors or those free of enhancing tumor after surgery and induction therapy were eligible to receive high-dose thiotepa.Thirty-nine patients (57%) completed the transplant regimen; their estimated median progression-free survival is 69 months and median overall survival has not been reached. Twelve transplanted patients (31%) relapsed. Neither histology nor prior low-grade oligodendroglioma correlated with relapse; however, persistent non-enhancing tumor at transplant conferred an increased risk of relapse (p = 0.028). The transplant regimen was well-tolerated; median hospital stay was 20 days (range: 7-43) with a median time to ANC and platelet engraftment of 10 days. Thirty patients (43%) did not receive high-dose thiotepa because of stable or progressive disease (n = 21), excessive toxicity (n = 4), refusal of further therapy (n = 2), failure to obtain insurance coverage (n = 2), or other (n = 1). No treatment-related or long-term neurotoxicity was seen in the transplanted patients.High-dose chemotherapy with stem cell rescue as initial treatment for anaplastic oligodendroglioma is feasible and associated with prolonged tumor control in some patients.
- Subjects :
- Oncology
Adult
Male
Cancer Research
medicine.medical_specialty
Vincristine
Autologous Stem Cell Rescue
Pathology
Adolescent
medicine.medical_treatment
Oligodendroglioma
ThioTEPA
Procarbazine
Lomustine
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Prospective Studies
neoplasms
Antineoplastic Agents, Alkylating
Aged
Aged, 80 and over
Chemotherapy
business.industry
Brain Neoplasms
Hematopoietic Stem Cell Transplantation
Middle Aged
medicine.disease
Prognosis
Combined Modality Therapy
nervous system diseases
Survival Rate
Neurology
Female
Neurology (clinical)
Stem cell
business
Thiotepa
medicine.drug
Subjects
Details
- ISSN :
- 0167594X
- Volume :
- 65
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of neuro-oncology
- Accession number :
- edsair.doi.dedup.....97744915066971a135b4f17b4bfb2674