Anticancer research · 2005
Efficacy and feasibility of procarbazine, ranimustine and vincristine chemotherapy, and the role of surgical resection in anaplastic oligodendroglioma.
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Yamamoto Masaaki, Iwaasa Mitsutoshi, Nonaka Masani, Tsugu Hitoshi, Nabeshima Kazuki, Fukushima Takeo
Аннотация
UNLABELLED: The safety, tolerance and preliminary efficacy of a chemotherapy regimen consisting of procarbazine (PCB), ranimustine (MCNU) and vincristine (VCR) were assessed for patients with newly diagnosed supratentorial anaplastic oligodendroglioma.
MATERIALS AND METHODS: Between October 1999 and September 2003, 5 patients were enrolled. The initial regimens were prescribed as adjuvant therapy in conjunction with radiotherapy following standard surgical treatment. All patients received a chemotherapy comprising ranimustine (100 mg/m2) intravenously on Day 1, procarbazine (60 mg/m2) on Days 8 to 21, and vincristine (1.4 mg/m2, maximum total 2 mg) on Days 8 and 29. The cycles were repeated every 8 weeks until tumor progression was evident, or for a total of 6 cycles over a 1-year period. The primary end-points were safety and tolerability, while the secondary end-point was overall survival.
RESULTS: Five consecutive eligible patients were treated. Of the 4 evaluable patients, 3 partially responded to the treatment (PR), while 1 had a complete response (CR): all patients are still alive. However, 3 of the 5 patients showed relapse, with a time to tumor progression (TTP) of 50, 143 and 241 weeks, respectively. Two of these patients received combined treatment with carboplatin, etoposide and recombinant human mutant tumor necrosis factor-alpha at the first relapse. This regimen appeared to be safe and neither neurological toxicity, severe or life-threatening hematological toxicity, nor fatal toxicity (WHO Grade 4) were experienced.
CONCLUSION: These results suggest that a chemotherapy regimen consisting of PCB, MCNU and VCR in this patient population seems to be safe and tolerable, and the response rate was high. Thus, wide resection with a risk of major neurological morbidity due to nearby functionally critical areas can be avoided. However, since the relapse rate was high, a second-line chemotherapy should be developed for anaplastic oligodendroglioma to improve the long-term control of the disease.
MATERIALS AND METHODS: Between October 1999 and September 2003, 5 patients were enrolled. The initial regimens were prescribed as adjuvant therapy in conjunction with radiotherapy following standard surgical treatment. All patients received a chemotherapy comprising ranimustine (100 mg/m2) intravenously on Day 1, procarbazine (60 mg/m2) on Days 8 to 21, and vincristine (1.4 mg/m2, maximum total 2 mg) on Days 8 and 29. The cycles were repeated every 8 weeks until tumor progression was evident, or for a total of 6 cycles over a 1-year period. The primary end-points were safety and tolerability, while the secondary end-point was overall survival.
RESULTS: Five consecutive eligible patients were treated. Of the 4 evaluable patients, 3 partially responded to the treatment (PR), while 1 had a complete response (CR): all patients are still alive. However, 3 of the 5 patients showed relapse, with a time to tumor progression (TTP) of 50, 143 and 241 weeks, respectively. Two of these patients received combined treatment with carboplatin, etoposide and recombinant human mutant tumor necrosis factor-alpha at the first relapse. This regimen appeared to be safe and neither neurological toxicity, severe or life-threatening hematological toxicity, nor fatal toxicity (WHO Grade 4) were experienced.
CONCLUSION: These results suggest that a chemotherapy regimen consisting of PCB, MCNU and VCR in this patient population seems to be safe and tolerable, and the response rate was high. Thus, wide resection with a risk of major neurological morbidity due to nearby functionally critical areas can be avoided. However, since the relapse rate was high, a second-line chemotherapy should be developed for anaplastic oligodendroglioma to improve the long-term control of the disease.