Interstitial chemotherapy with mitoxantrone in recurrent malignant glioma: preliminary data

1996 ◽  
Vol 27 (2) ◽  
Author(s):  
Amerigo Boiardi ◽  
Andrea Salmaggi ◽  
Annalisa Pozzi ◽  
Giovanni Broggi ◽  
Antonio Silvani
Keyword(s):  
Malignant Glioma ◽  
Preliminary Data ◽  
Recurrent Malignant Glioma ◽  
Interstitial Chemotherapy

Interstitial chemotherapy with drug polymer implants for the treatment of recurrent gliomas

1991 ◽  
Vol 74 (3) ◽  
pp. 441-446 ◽  
Author(s):  
Henry Brem ◽  
M. Stephen Mahaley ◽  
Nicholas A. Vick ◽  
Keith L. Black ◽  
S. Clifford Schold ◽  
...  
Keyword(s):  
Malignant Glioma ◽  
Dose Group ◽  
Malignant Gliomas ◽  
Chemotherapeutic Agents ◽  
Therapeutic Drug ◽  
Recurrent Malignant Glioma ◽  
Content Type ◽  
Interstitial Chemotherapy ◽  
Bcnu Wafer ◽  
Fine Print

✓ Malignant gliomas have been difficult to treat with chemotherapy. The most effective agent, BCNU (carmustine), has considerable systemic toxicity and a short half-life in serum. To obviate these problems, a method has been developed for the local sustained release of chemotherapeutic agents by their incorporation into biodegradable polymers. Implantation of the drug-impregnated polymer at the tumor site allows prolonged local exposure with minimal systemic exposure. In this Phase I–II study, 21 patients with recurrent malignant glioma were treated with BCNU released interstitially by means of a polyanhydride biodegradable polymer implant. Up to eight polymer wafers were placed in the resection cavity intraoperatively, upon completion of tumor debulking. The polymer releases the therapeutic drug for approximately 3 weeks. Three increasing concentrations of BCNU were studied; the treatment was well tolerated at all three levels. There were no adverse reactions to the BCNU wafer treatment itself The average survival period after reoperation was 65 weeks for the first dose group, 64 weeks for the second dose group, and 32 weeks for the highest dose group. The overall mean survival time was 48 weeks from reoperation and 94 weeks from the original operation. The overall median survival times were 46 weeks postimplant and 87 weeks from initial surgery. Eighteen (86%) of 21 patients lived more than 1 year from the time of their initial diagnosis and eight (38%) of 21 patients lived more than 1 year after intracranial implantation of the polymer. Frequent hematology, blood chemistry, and urinalysis tests did not reveal any systemic effect from this interstitial chemotherapy. Since the therapy is well tolerated and safe, a placebo-controlled clinical trial has been started. The trial will measure the effect of the second treatment dose on survival of patients with recurrent malignant glioma.

scholarly journals Pharmacokinetic and Tumor Distribution Characteristics of Temsirolimus in Patients with Recurrent Malignant Glioma

2007 ◽  
Vol 13 (24) ◽  
pp. 7401-7406 ◽  
Author(s):  
J. G. Kuhn ◽  
S. M. Chang ◽  
P. Y. Wen ◽  
T. F. Cloughesy ◽  
H. Greenberg ◽  
...  
Keyword(s):  
Malignant Glioma ◽  
Distribution Characteristics ◽  
Recurrent Malignant Glioma ◽  
Tumor Distribution

scholarly journals 3D Conformal Radiotherapy and Cisplatin for Recurrent Malignant Glioma

2008 ◽  
Vol 35 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Lauren VanderSpek ◽  
Barbara Fisher ◽  
Glenn Bauman ◽  
David Macdonald
Keyword(s):  
Malignant Glioma ◽  
Malignant Gliomas ◽  
Conformal Radiotherapy ◽  
Maximum Tolerated Dose ◽  
External Beam Radiation ◽  
Recurrent Malignant Glioma ◽  
Beam Radiation ◽  
Fractionated Radiotherapy ◽  
3D Conformal Radiotherapy ◽  
Grade 3

Purpose:To determine the maximum tolerated dose of 3D conformal radiotherapy in combination with Cisplatin for patients with recurrent malignant gliomas.Methods:From 1999-2003, nine patients with recurrent malignant glioma received fractionated radiotherapy and Cisplatin (20 mg/m2/d IV on days 1-5) in a Phase I radiation dose escalation trial. Three sequential dose levels were evaluated: 25 Gy, 30 Gy, and 35 Gy, using 5 Gy fractions. All patients received prior external beam radiation (median dose 59.4 (20-60) Gy) and five patients received prior chemotherapy.Results:Six male and three female patients were enrolled with a median age of 52 years, and a median Karnofsky performance status score of 70. The median re-irradiated tumor volume was 18.9 (0.1-78.5) cm3 and the median follow-up was 8.8 (3.2-31.2) months. One patient (30 Gy/ 6 fractions) experienced medically reversible acute grade 3 toxicity. A second patient (35 Gy/ 7 fractions) experienced acute grade 2 toxicity and histology showed tumor and radiation effect. A third patient (25 Gy/ 5 fractions) experienced late grade 3 toxicity from radiation necrosis. The radiological responses consisted of complete response (1 patient), partial response (1 patient), and stable disease (2 patients). The median overall survival was 8.8 months (95% CI 8.0-9.9), and the median disease free interval was 2.0 months (95% CI 1.4-4.4). Seven patients received chemotherapy following re-irradiation and Cisplatin.Conclusion:The maximum tolerated dose of 3D conformal fractionated radiotherapy was 30 Gy in 6 fractions with low dose Cisplatin, which was well tolerated in terms of acute toxicity for our patient population. This regimen demonstrated only modest efficacy in the treatment of recurrent malignant glioma. Combinations of conformal re-irradiation and other systemic agents may merit investigation. Currently our recommended dose is 30 Gy in 6 fractions for selected patients.

Irinotecan Treatment for Recurrent Malignant Glioma Using an Every-3-Week Regimen

2002 ◽  
Vol 25 (2) ◽  
pp. 204-208 ◽  
Author(s):  
Timothy F. Cloughesy ◽  
Emese Filka ◽  
Gillian Nelson ◽  
Fairooz Kabbinavar ◽  
Henry Friedman ◽  
...  
Keyword(s):  
Malignant Glioma ◽  
Recurrent Malignant Glioma

scholarly journals Boron Neutron Capture Therapy and Add-on Bevacizumab in Patients with Recurrent Malignant Glioma

2021 ◽  
Author(s):  
Motomasa Furuse ◽  
Shinji Kawabata ◽  
Masahiko Wanibuchi ◽  
Hiroyuki Shiba ◽  
Koji Takeuchi ◽  
...  
Keyword(s):  
Malignant Glioma ◽  
Boron Neutron Capture Therapy ◽  
Survival Data ◽  
Neutron Capture ◽  
Radiation Necrosis ◽  
Neutron Capture Therapy ◽  
Recurrent Malignant Glioma ◽  
Primary Glioblastoma ◽  
Boron Neutron Capture ◽  
Grade 3

Abstract Introduction: Boron neutron capture therapy (BNCT) has shown excellent survival data but increases in radiation necrosis against recurrent malignant glioma (MG) in previous studies. We proposed that bevacizumab may reduce radiation injury from BNCT by re-irradiation. We evaluated the efficacy and safety of a combination therapy of BNCT and add-on bevacizumab in patients with recurrent MG.Methods: Patients with recurrent MG were treated with reactor-based BNCT. Treatment with bevacizumab (10 mg/kg) was initiated 1–4 weeks after BNCT irradiation and was re-administered every 2–3 weeks until disease progression. Initially diagnosed glioblastomas were categorized as primary glioblastoma (pGBM) and other forms of MG were categorized as non-pGBM. Results: Twenty-five patients (14 with pGBM and 11 with non-pGBM) were treated with BNCT and add-on bevacizumab. The 1-year survival rate for pGBM and non-pGBM was 63.5% (95% CI, 33.1–83.0) and 81.8% (95%CI, 44.7–95.1), respectively. The median OS was 21.4 months (95% CI, 7.0–36.7) and 73.6 months (95% CI, 11.4–77.2) for pGBM and non-pGBM, respectively (p = 0.0428). The median PFS was 8.3 months (95%CI, 4.2–12.1) and 15.6 months (95% CI, 3.1–29.8) for pGBM and non-pGBM, respectively (p = 0.0207). Alopecia occurred in all patients. Six patients experienced adverse events ≥ grade 3.Conclusions: BNCT and add-on bevacizumab were found to provide both a long OS and a long PFS, compared to the previous studies of BNCT alone for recurrent MG. The add-on bevacizumab may reduce the detrimental effects of BNCT radiation, including pseudoprogression and radiation necrosis.

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