Eight‐drugs‐in‐one‐day chemotherapy in postirradiated adult patients with malignant gliomas

Jack M. Rozental*, H. Ian Robins, Jonathan Finlay, Barbara Healey, Allan B. Levin, Richard A. Steeves, Peter C. Kohler, Henry S. Schutta, Donald L. Trump

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Fifteen patients, 12 with glioblastoma multiforme and 3 with anaplastic astrocytoma, were treated with “eight‐drugs‐in‐one‐day” chemotherapy methylprednisolone 300 mg/m2, vincristine 1.5 mg/m2 (maximum of 2 mg/cycle), CCNU 75 mg/m2, procarbazine 75 mg/m2, hydroxyurea 3,000 mg/m2, cisplatin 90 mg/m2, cytosine arabinoside 300 mg/m2, and imidazole carboxamide 150 mg/m2. All patients had prior brain irradiation but none had previous chemotherapy. The population included 10 patients with progressive disease after irradiation and 5 who presented within 2 months of completing radiation. Patients received an average of 5 monthly cycles of chemotherapy. Three patients achieved a complete and 2 a partial response (CR + PRrate was 33%). The median survival time was 46 weeks, Myelosuppression was the doselimiting toxicity. Leucocyte counts between 2.0‐4.5 × 103/mm3 were observed in 40% of patients, between 1.0‐<2.0 × 103/mm3 in 33%, and < 1.0 × 103/mm3 in 7%. Platelet counts between 50‐130 × 103/mm3 were observed in 27% of patients, and < 50 × 103/mm3 in 33%. Six patients suffered infections, 4 had reversible renal toxicity, 2 developed paresthesias, and one a debilitating myopathy related to treatment with dexamethasone. Ototoxicity was seen in 3 patients. Two patients developed pulmonary emboli. Nine patients had nausea and vomiting, in one case associated with Candida esophagitis. One long‐term survivor developed necrosis of the corpus callosum and dementia. Four patients discontinued treatment after an average of 3.5 cycles because of toxicity. Although extremely toxic, this regimen has modest activity in previously irradiated adult patients with malignant glioma.

Original languageEnglish (US)
Pages (from-to)471-476
Number of pages6
JournalMedical and Pediatric Oncology
Volume17
Issue number5-6
DOIs
StatePublished - 1989

Keywords

  • chemotherapy
  • eight‐drugs‐in‐one‐day chemotherapy
  • glioblastoma
  • malignant glioma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Eight‐drugs‐in‐one‐day chemotherapy in postirradiated adult patients with malignant gliomas'. Together they form a unique fingerprint.

Cite this