Karen[a]
Radiotherapy and concomitant weekly carboplatin and daily etoposide for patients with inoperable biopsy proven glioblastoma multiforme.
Abstract No: 1544
Author(s): J. M. Simon, G. Noel, K. Hoang-Xuan, A. F. Carpentier, K. Mokhtari, S. Racadot, F. Baillet, J. J. Mazeron; Pitie-Salpetriere Hospital, AP-HP, Paris, France
Background:
This study was performed to evaluate the toxicity and efficacy of concomitant carboplatin and etoposide with external beam radiotherapy in the management of inoperable glioblastoma.
Methods:
From 8/99 to 10/01, 26 consecutive patients with inoperable biopsy proven glioblastoma were treated with radiotherapy (59.4 Gy in 1.8 Gy/fraction), weekly carboplatin (area under curve = 1.5), and etoposide (given daily as a single oral dose of 50 mg, 1 hour before each treatment session). Informed consent was obtained from all patients. This experimental group was compared to an historical group of 24 patients with inoperable biopsy proven glioblastoma treated with definitive radiotherapy in our institution. Acute toxicity was graded according to World Heath Organization criteria and scored weekly during treatment and within 2 months after the end of therapy. The primary endpoint of this study was overall survival.
Results:
The two groups of patients were matched for sex ratio, age (median: 55 years [range, 31 to 69 years] and 56 years [range, 40 to 69 years], for the experimental and control groups respectively), tumor location, tumor extension, Karnofsky performance status (median: 80 [range, 60 to 100] and 90 [range, 60 to 100], for the experimental and control groups respectively), and the RTOG recursive partitioning analysis (RPA) classes. The median follow-up was sixty-eight weeks. Median survival times were 40 and 36 weeks, and the 1-year overall survival rates were 46% and 4%, respectively for patients treated with carboplatin and etoposide, and for those treated in the control group (p < 0.02). Carboplatin and etoposide were well tolerated. The incidence of grade 3 and 4 hematological toxicity related to chemotherapy was 12% in the experimental group.
Conclusions; Concomitant radiation plus weekly carboplatin and daily etoposide was safe and well tolerable. This regimen seemed to increase overall survival in patients with unresectable glioblastoma. A larger randomized trial is warranted to confirm these results.
Event: 2004 ASCO Annual Meeting
Presenter: Jean Marc Simon, MD