Abstract
BackgroundThe optimal chemotherapeutics of recurrent disseminated glioblastoma has yet to be determined. We analyzed the efficacy and safety of recombinant human endostatin (rh-ES) combined with temozolomide and irinotecan in patients with recurrent disseminated glioblastoma.MethodsWe retrospectively reviewed 30 adult patients with recurrent disseminated glioblastoma treated with this combination chemotherapy at Department of Neuro-Oncology, Sanbo Brain Hospital, Capital Medical University of China from November 2009 to August 2018. Temozolomide was given orally at 200 mg/m2 daily for 5 days and rh-ES was administrated 15 mg/d daily for 14 days of each 28-day treatment cycle. Irinotecan was given intravenously every 2 weeks on a 28-day cycle at 340 mg/m2 or 125 mg/m2 depending on antiepileptic drugs. Primary endpoint was progression-free survival (PFS) at 6 months (6 m-PFS).ResultsThe 6 m-PFS was 23.3%. The median PFS was 3.2 months. The overall survival rate (OS) at 12 months was 28.6%. The median OS was 6.9 months. Six out of 30 (20%) patients demonstrated partial radiographic response and 11 (36.7%) remained stable. The PFS of the 6 patients who got partial response was 5.8, 6.3, 6.9, 13.6, 15.8 and 16.6 months, respectively, and the median time interval of first response was 4 (range, 2.0–6.6) months. The most common adverse events were hematologic toxicities and gastrointestinal effects. The Grade ≥ 3 adverse event was hematologic toxicities. The adverse events were manageable.ConclusionsRh-ES, in combination with cytotoxic drugs, was an alternative effective regimen with manageable toxicities in treatment of recurrent disseminated glioblastoma.
Highlights
The optimal chemotherapeutics of recurrent disseminated glioblastoma has yet to be determined
We retrospectively analyzed the effect and toxicity of recombinant human endostatin (rh-ES) when combined with traditional cytotoxic drugs on adult recurrent disseminated glioblastoma
Patients selection We performed a retrospective observational study for all adult patients with recurrent disseminated glioblastoma treated with the combined regimens of temozolomide (TMZ), irinotecan (CPT-11) and rh-ES at Department of Neuro-Oncology, Sanbo Brain Hospital, Capital Medical University from November 2009 to August 2018
Summary
Inclusion criteria were as follows: Age at 18–70 years old; Histological diagnosis of glioblastoma, the glioblastoma secondary to low-grade gliomas were included; Recurrence was confirmed histologically or by radiographic evidence after surgery and adjuvant radiotherapy; Intracranial and/or spinal cord disseminated lesions at recurrence, whether lesions were disseminated at diagnosis was not limited; Treated with at least one cycle of the combined chemotherapy (TMZ, CPT-11 and rh-ES); Had at least one posttreatment radiographic follow-up. The clinical data collected included the following: Age, sex, previous therapies, number of relapse, treatment cycles, response, adverse events, subsequent treatments, progression date and dead date. Secondary endpoints were median PFS, OS, OS at 12 months (12 m-OS), objective response rate (ORR), disease control rate (DCR) and adverse events. Method of evaluation Contrast-enhanced MRI was performed at baseline and every 2 cycles thereafter until disease progression. All statistical analyses were performed using SPSS 17.0. p < 0.05 was considered to be statistically different
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