Clinical observation of carboplatin in combination with temozolomide dose-dense regimen for recurrent glioblastoma

Abstract

Objective To investigate the effectiveness, tolerability and safety of carboplatin in combination with temozolomide (TMZ) dose-dense regimen for the treatment of recurrent glioblastoma (GBM). Methods From February 2013 to March 2014, 9 adult patients with recurrent GBM received carboplatin in combination with temozolomide dose-dense regimen at the Department of Radiotherapy, the First Hospital of Jilin University were collected. The specific regimen: carboplatin 350 mg/m2 at day 1; TMZ 150 mg·m-2·d-1, at day 1-7 and day 15-21, and 28 days were a circle. The follow-up time ranged from 5 to 16 months. Results Four cycles of chemotherapy were performed in 7 patients; 5 cycles of chemotherapy were performed in 2 patients. The main toxic reactions were hematological toxic reactions, gastrointestinal reactions, and fatigue. Three patients had grade Ⅰ-Ⅱ of bone marrow suppression; 6 patients had grade Ⅲ-Ⅳ of bone marrow suppression. All patients had mild to moderate gastrointestinal reactions including anorexia and vomiting. All the above adverse reactions were alleviated after symptomatic treatment; none of them had treatment-related deaths. Five patients died of tumor progression. The progression-free survival rate of 6 months was 44% (4/9); the imaging remission rate (PR) was 44% (4/9); the symptom improvement rate was 67% (6/9); and the 1-year survival rate was 22% (2/9). Conclusions Carboplatin in combination with TMZ dose-dense regimen for the treatment of recurrent GBM was effective. Most of the patients with 4-5 cycles of chemotherapy could tolerate it. No severe irreversible adverse reactions occurred. Key words: Glioblastoma; Recurrence; Antineoplastic combined chemotherapy protocols; Carboplatin; Temozolomide