PROCARBAZINE, LOMUSTINE, VINCRISTINE FOR THE SECOND LINE TREATMENT OF GLIOBLASTOMA MULTIFORME

Abstract

Abstract AIMS Most patients with glioblastoma recur despite surgery and post-operative chemoradiation. The optimal second line chemotherapy regime is not known. The aim of this study was to evaluate PCV chemotherapy given as second line treatment for glioblastoma. METHOD Data was collected for all patients with glioblastoma treated with second line PCV between 2009 and 2021 at the Norfolk and Norwich University Hospital. All underwent surgical resection either complete or incomplete resection followed by adjuvant radiotherapy and chemotherapy according to the Stupp or Perry A protocol. All received palliative PCV chemotherapy at recurrence. The Response Assessment in Neuro-Oncology (RANO) criteria were used to assess response to palliative PCV chemotherapy. Patient and disease related characteristics were described. Disease free survival from recurrence to death and survival outcomes were estimated using Kaplan-Meir method. RESULTS 70 patients were evaluated. Overall survival from surgery to death was 290 days (95%CI 245 to 318) Survival from disease progression to death was 182 days (95%CI 131 to 218). Subgroup analysis was performed for patients <65years and >65years. For patients <65 years N=51, median overall survival was 199 days (95%CI 142 to 353) p value 0.1246. For those >65 years N=16, median overall survival was 130.5 days (95%CI 93 to 227) CONCLUSIONS Using PCV as a second line chemotherapy for patients with glioblastoma is a reasonable approach. It is well tolerated and provides benefit for patients <65 years as well as older patients.