Platinum analogues in the treatment of recurrent high grade astrocytoma

Autor: B. Kupelnick, D. Bishop, M. Huncharek
Rok vydání: 1998
Předmět:
Zdroj: Cancer Treatment Reviews. 24:307-316
ISSN: 0305-7372
DOI: 10.1016/s0305-7372(98)90054-8
Popis: Primary brain tumours are a major cause of cancerrelated morbidity and mortality in the United States. Despite the development of aggressive multi-modality therapy regimens, median survivals for patients with these malignancies remain poor (1). Surgery followed by radiation therapy increases survival from a median of 14 weeks with surgery alone to 35-48 weeks when followed by radiation (2). Multimodality therapy including chemotherapy is the standard clinical approach in many centers in the U.S., although the addition of cytotoxic chemotherapy to the treatment regimen has only a modest effect on median survival. A recent meta-analysis showed that adding chemotherapy to surgery and radiation improved the median survival duration from 9.4 to 12 months (3). At present, the nitrosoureas, particularly carmustine (BCNU) and lomustine (CCNU), are the most frequently used agents in primary brain tumors (4). These drugs are highly lipid soluble, readily cross the blood-brain barrier and are considered among the most effective against these tumours. In recurrent glioma, the response data are difficult to interpret owing to heterogeneity in clinical trials and the use of varying response criteria. Nonetheless, objective response rates for patients with recurrent high grade glioma treated with BCNU are reported to range from 2030% (4). Unfortunately, these statistics are based on a number of studies conducted before the availability of computerized tomography (CT). Few studies exist which examine other single-agent therapies for recurrent glioma. Some of the other chemotherapeutic
Databáze: OpenAIRE
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