AI Summary & Key Takeaways
AI InsightIn the GBM group, median progressionfree survival (PFS) and overall survival (OS) were 3 (95% CI, 2.31-3.69) and 8 (95% CI, 4.76-11.24) months, respectively.
📌 3 Key Takeaways
Abstract
Eventually, all patients with malignant gliomas recur or progress. Unfortunately, the optimal regimen in the salvage setting has not yet been defined. We retrospectively evaluated 52 patients with malignant gliomas who failed temozolomide therapy and were treated with a combination of intravenous carboplatin and oral cyclophosphamide. The median age of all patients, including those with glioblastoma multiforme (GBM) (n= 40) and anaplastic glioma (AG) (n= 12), was 45.5 years (range 23-68). All patients were treated with consolidation temozolomide after chemoradiotherapy. After temozolomide failure, second surgery was performed on 15, reirradiation on four and radiosurgery on three patients. The median number of chemotherapy cycles was 4 (range 1-8), the clinical benefit was 67.3%, a partial response was achieved in 26.9% and stable disease in 40.4%. In the GBM group, median progressionfree survival (PFS) and overall survival (OS) were 3 (95% CI, 2.31-3.69) and 8 (95% CI, 4.76-11.24) months, respectively. In the AG group, median PFS and OS were 5 (95% CI, 3.51-6.49) and 11 (95% CI, 6.38-15.62) months, respectively. The six-month PFS rate was 25%. Only one patient survived 18 months after treatment. Serious toxicity was mainly hematological. The combination of carboplatin and oral cyclophosphamide is a valuable option in temozolomide refractory patients with malignant glioma.
Özet
Malign glial tümörlü hastalar sonuçta progrese olur veya tekrarlar ve bu durumda optimal tedavi henüz tanımlanmamıştır. Temozolomid tedavi başarısızlığından sonra intravenöz karboplatin ve oral siklofosfamid kombinasyonu ile tedavi edilen malign gliomlu 52 hastayı retrospektif olarak değerlendirdik. Glioblastoma multiforme (GBM) (n= 40) ve anaplastik gliomlu (AG) (n= 12) tüm hastaların ortanca yaşları 45.5 (aralık, 23-68) idi. Tüm hastalar kemoradyoterapi sonrası konsolidasyon temozolomid ile tedavi edildiler. Temozolomid başarısızlığı sonrası, 15 hastaya ikinci cerrahi, dört hastaya ikincil radyoterapi ve üç hastaya da radyocerrahi uygulandı. Ortanca kemoterapi kürü 4 (aralık, 1-8) idi. Klinik fayda oranı %67.3, kısmi yanıt %26.9 ve stabil hastalık %40.4 idi. GBM grubunda ortanca progresyonsuz sağkalım (PS) ve genel sağkalım (GS) sırası ile 3 ay (%95 CI, 2.31-3.69) ve 8 aydı (%95 CI, 4.76-11.24). AG grubunda ortanca PS ve GS sırası ile 5 ay (%95 CI, 3.51-6.49) ve 11 aydı (%95 CI, 6.38-15.62). Altı ay PS oranı %25 idi. Sadece bir hasta tedavi sonrası 18 ay yaşadı. Ciddi toksisiteler esas olarak hematolojikti. Karboplatin ve oral siklofosfamid kombinasyonu temozolomid refrakter malign glial tümörlü hastalarda dikkate değer seçenektir.