Jens[a]
Den folgenden Artikel habe ich in der Medline gefunden. Dieses Topotecan-Schema scheint keinen Vorteil zu bringen. Kennt jemand Ergebnisse zu dem Versuch mit Topotecan während der Strahlentherapie, der in Hessen läuft. Viele Glioblastom-Patienten werden heute mit einer anderen Option, nämlich "Temodal während der Strahlentherapie", regelrecht überfahren. Gibt es dazu schon Ergebnisse, die einen Vorteil belegen. Unser Strahlentherapeut lehnte eine Chemo während der Erst-Strahlentherapie ab. Er berief sich auf Studien, die belegen sollen, dass eine Chemo während der Strahlentherapie eher von Nachteil für die Überlebenszeit des Patienten ist. Kennt jemand von Euch radiosensibilisierende Mittel, mit denen die Effektivität der Glioblastom-Behandlung nachweislich verbessert werden kann?. Danke!
J Clin Oncol 2001 Feb 15;19(4):1111-1117
Phase I Study of Topotecan Plus Cranial Radiation for
Glioblastoma Multiforme: Results of Radiation Therapy
Oncology Group Trial 9507.
Fisher BJ, Scott C, Macdonald DR, Coughlin C, Curran WJ
Departments of Radiation Oncology and Medical Oncology, London
Regional Cancer Center, and Departments of Oncology and Clinical
Neurological Sciences, University of Western Ontario, London, Ontario,
Canada.
PURPOSE: A phase I trial was conducted by the Radiation Therapy
Oncology Group (RTOG) to determine the maximum-tolerated dose of
topotecan that could be safely combined with standard cranial radiation
for glioblastoma multiforme. A secondary objective was to document the
acute and late toxicities of this combination of chemotherapy and
radiation. PATIENTS AND METHODS: Forty-seven patients with
histologically confirmed glioblastoma multiforme were entered onto this
phase I trial. Three cycles of topotecan were administered at 21-day
intervals commencing at day 1 of cranial radiotherapy (60 Gy/30
fractions). Each cycle consisted of daily 30-minute intravenous (IV)
infusions for 5 days. The dose of topotecan was escalated in three-dose
increments from 0.5 mg/m(2)/d to 1.0 mg/m(2)/d to 1.5 mg/m(2)/d in
different patient groups. RESULTS: The majority of patients were over
age 50. Three dose levels of topotecan were tested. Fifteen patients
accrued to level 1 (topotecan dose 0.5 mg/m(2)/d). No grade 4 toxicities
were seen. Sixteen patients accrued to level 2 (topotecan dose 1.0
mg/m(2)/d), five of whom had brief episodes of grade 4 neutropenia.
Seventeen patients accrued to level 3 (1.5 mg/m(2)/d). Six of these
patients had brief episodes of grade 4 neutropenia and four developed
grade 3 thrombocytopenia. No serious nonhematologic or late toxicities
were seen. Median survival for all patients was 9.7 months. There was
no apparent difference in survival by topotecan dose schedule.
CONCLUSION: Toxicity was acceptable at an IV topotecan dose of
1.5 mg/m(2)/d administered daily for 5 days every 21 days for three
cycles. A phase II trial has been performed using this dose of topotecan.