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PCV and/or TMZ chemotherapy in 255 gliomas. Analysis of the clinical experience from a neuro-oncology data-base.

Al Musella's Comments: (This is his personal views and are not necessarily the views of the Musella Foundation!)


Posted on: 06/08/2004

PCV and/or TMZ chemotherapy in 255 gliomas. Analysis of the clinical experience from a neuro-oncology data-base.

Meeting: 2004 ASCO Annual Meeting
Category: Central Nervous System Tumors
SubCategory: CNS Tumors

Abstract No: 1538
Author(s): A. Pace, A. Pompili, M. Maschio, E. Galie', S. Telera, B. Jandolo, E. Occhipinti, C. M. Carapella; Regina Elena Nat. Cancer Inst., Rome, Italy

Background: The role of chemotherapy (CT) in the treatment of malignant gliomas is still debated. Different chemotherapeutic agents are currently used with modest impact on survival. At the moment there are no clear-cut data indicating more effective or better-tolerated treatments. Furthermore the evaluation of response to CT should include also clinical benefit and quality of life.

Methods: We retrospectively analyzed our experience in chemotherapy of malignant gliomas with the aim of evaluating time to tumor progression, clinical benefit, quality of life (EORTC QLQ-C30), and toxicity. Results: 255 recurrent malignant glioma patients were treated with chemotherapy (PCV or Temozolomide) in our Institution since 1997. Histology was: Glioblastoma (GB) in 123; Anaplastic astrocytoma (AA) 56; Mixed Anaplastic Oligo-Astrocytoma (AO) 43; Progressive Low Grade Astrocytoma (LGA) 42; Anaplastic Oligos (O) 28. The overall response rate (RR) by histology was: CR+PR in GB 7.4%; AA 26.8%; AO 51.6%; LGA 48.4%; O 44.4%. Treatment schedule was PCV in 193 patients and Temozolomide (TMZ) standard schedule in 129. RR was not significant different for the two treatments. 69 patients received two line of chemotherapy (44 first line PCV and 25 first line TMZ). In the present series, tumors which respond at first line CT are more likely to respond to second line treatment. In 13.5% patients treated with PCV the treatment was interrupted for toxicity. During TMZ treatment 10.9% of patients presented myelotoxicity grade 3-4 (WHO), leading to treatment interruption in 4.6% of cases.

Conclusions: Considering the modest influence of CT on overall survival in malignant gliomas, less toxic drugs should be preferred for first line treatment.

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