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Titolo:
Phase I and pharmacokinetic study of preirradiation chemotherapy with BCNU, cisplatin, etoposide, and accelerated radiation therapy in patients with high-grade glioma
Autore:
Rajkumar, SV; Buckner, JC; Schomberg, PJ; Reid, JM; Bagniewski, PJ; Ames, MM; Cascino, TL; Marks, RS;
Indirizzi:
Mayo Clin & Mayo Fdn, Div Med Oncol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 ncol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Div Radiat Oncol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 ncol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Div Dev Oncol Res, Rochester, MN 55905 USA Mayo Clin& Mayo Fdn Rochester MN USA 55905 Res, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Dept Neurol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 urol, Rochester, MN 55905 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
fascicolo: 5, volume: 42, anno: 1998,
pagine: 969 - 975
SICI:
0360-3016(199812)42:5<969:PIAPSO>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
CELL LUNG-CANCER; DOSE-RATE IRRADIATION; ORAL ETOPOSIDE; MALIGNANT GLIOMAS; RANDOMIZED TRIAL; RADIOTHERAPY; SURGERY; NITROSOUREAS; ASTROCYTOMA; CARMUSTINE;
Keywords:
brain tumors; chemotherapy; radiation therapy; glioblastoma; anaplastic astrocytoma; BCNU; cisplatin; etoposide;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Buckner, JC Mayo Clin & Mayo Fdn, Div Med Oncol, 200 1st St SW, Rochester,MN 55905 USA Mayo Clin & Mayo Fdn 200 1st St SW Rochester MN USA 55905 USA
Citazione:
S.V. Rajkumar et al., "Phase I and pharmacokinetic study of preirradiation chemotherapy with BCNU, cisplatin, etoposide, and accelerated radiation therapy in patients with high-grade glioma", INT J RAD O, 42(5), 1998, pp. 969-975

Abstract

Purpose: We conducted a Phase I study of bischloroethylnitrosourea (BCNU),cisplatin, and oral etoposide administered prior to and during acceleratedhyperfractionated radiation therapy in newly diagnosed high-grade glioma. Pharmacokinetic studies of oral etoposide were also done. Methods and Materials: Patients started chemotherapy after surgery but prior to definitive radiation therapy (160 cGy twice daily x 15 days; 4800 cGytotal). Initial chemotherapy consisted of BCNU 40 mg/m(2) days 1-3, cisplatin 30 mg/m(2) days 1-3 and 29-31, and etoposide 50 mg orally days 1-14 and29-42, repeated in 8 weeks concurrent with radiation therapy. BCNU 200 mg/m(2) every 8 weeks x 4 cycles was given after radiation therapy. Results: Sixteen patients, 5 with grade 3 anaplastic astrocytoma and 11 with glioblastoma were studied. Grade 3-4 leukopenia (38%) and thrombocytopenia (31%) were dose-limiting. Other toxicities were anorexia (81%), nausea (94%), emesis (56%), alopecia (88%), and ototoxicity (38%). The maximum tolerated dose was BCNU 40 mg/m2 days 1-3, cisplatin 20 mg/m(2) days 13 and 29-31, and oral etoposide 50 mg days 1-21 and 29-49 prior to radiation therapyand repeated in 8 weeks with the start of radiation therapy followed by BCNU 200 mg/m2 every 8 weeks for 4 cycles. Median time to progression and survival were 13 and 14 months respectively. Responses occurred in 2 of 9 (22%) patients with evaluable disease. In pharmacokinetic studies, all patientsachieved plasma concentrations of >0.1 mu g/ml etoposide (the in vitro radiosensitizing threshold), following a 50 mg oral dose. The mean rt SD 2 hr and 6 hr plasma concentrations were 0.92 +/- 0.43 mu g/ml and 0.36 +/- 0.12mu g/ml, respectively. Estimated duration of exposure to >0.1 mu g/ml etoposide was 10-17 hr. Conclusions: Preirradiation chemotherapy with BCNU, cisplatin, and oral etoposide with accelerated hyperfractionated radiation therapy in high-grade gliomas is feasible and merits further investigation. Sustained radiosensitizing concentrations can be achieved with low oral doses of etoposide. (C) 1998 Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 15/07/20 alle ore 13:12:23