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This abstract is from a paper presented to the American Society of Clinical Oncology.
Use of modified PCV chemotherapy as principal therapy for adults with incompletely resected or recurrent low-grade glioma: A retrospective review
EB Arenson, J Bank, M Pierick, C Greenwald, J McVicker, JP Elliott, JD Day, TM Fullagar; The Colorado Neurological Institute, Englewood, Colorado
Background: In order to assess outcomes of patients treated with chemotherapy versus a more standard approach of radiotherapy (RT), we reviewed 48 patients with newly diagnosed, partially resected or recurrent low-grade glioma (LGG) treated between 1996 and the present.
Methods: Patients were divisible into three groups: those treated with chemotherapy + RT before (Group A, 28 patients) or after (Group B, 13 patients) radiographic progression, and those with recurrences after treatment with RT (Group C, 7 patients). Diagnoses included astrocytoma (23%), oligodendroglioma (48%) and mixed glioma (29%). 39 patients were treated with chemotherapy alone and 9 received post-chemotherapy RT. Chemotherapy consisted of PCV in one case; all other patients received modified PCV (MPCV), which variably included addition of carboplatin (200-360 mg/m2) and etoposide (150 mg/m2) and substitution of temozolomide (150 mg/m2/day x 5 doses) for procarbazine. The intent was to treat monthly for one year.
Results: Patients received a mean of 10 courses of MPCV; 481 cycles were given. There were no deaths or admissions during chemotherapy. Grade III/IV toxicities occurred in 108 cycles (25 patients), 107 hematologic and 1 GI. Late effects included 1 case of MDS and 1 AML. There were no cases of disease progression during chemotherapy. Two patients stopped MPCV early, one because of worsening seizures (2 cycles) and one by personal preference (1 cycle); both died of disease. With a median follow-up of 46 months (range 4-120) from initiation of chemotherapy, overall survival and progression-free survival were 89% and 79% for Group A, 91% and 83% for Group B, and 100% and 86% for Group C. Of 6 patients (12.5%) who recurred after completing chemotherapy, 2 have died; both had received post-chemotherapy RT and had clinical features of GBM. Four patients are either lost to follow-up (2) or alive with stable disease (2) following additional treatment.
Conclusions:
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Colorado Neurological
Institute Center for Brain & Spinal Tumors
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