Abstract
BackgroundThe role of Procarbazine Lomustine and Vincristine (PCV) chemotherapy is already established in terms of improving survival in low-grade glioma (LGG). This improved survival has led to the increasing administration of PCV to LGG patients over the past years. However, like other chemotherapies, serious hematological and non-hematological toxicities may occur. The purpose of this study was to evaluate the toxicity profile of PCV and its clinical relevance in our practice. Materials and MethodsWe reviewed 63 patients of LGG retrospectively who received chemotherapy PCV between January 2015 and January 2018 at Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore.ResultsSignificant hematological toxicity as grade 3 anemia, thrombocytopenia, and neutropenia occurred in 19%, 27%, and 46% respectively with PCV. Other toxicities such as neurotoxicity, vomiting and derangement of liver enzymes occurred in 3.2%, 19%, and 19% respectively. Patients who were on concurrent anticonvulsants had no increase in PCV toxicity. Survival was not impacted by hematological toxicities up to grade 3.ConclusionPCV chemotherapy is associated with major hematological, hepatic, and clinical toxicities (vomiting, constipation, and neuropathy). Hematological toxicities influenced the course of treatment in terms of delays and interruptions.
Highlights
Low-grade glioma (LGG) is somewhat a rare disease entity, which constitutes about 15% of all primary brain tumors, occurring commonly in young adults [1]
The role of Procarbazine Lomustine and Vincristine (PCV) chemotherapy is already established in terms of improving survival in low-grade glioma (LGG)
Significant hematological toxicity as grade 3 anemia, thrombocytopenia, and neutropenia occurred in 19%, 27%, and 46% respectively with PCV
Summary
Low-grade glioma (LGG) is somewhat a rare disease entity, which constitutes about 15% of all primary brain tumors, occurring commonly in young adults [1]. Patient-related factors included patient age, performance status, neurologic deficits or mental changes, the presentation with seizure activity, and pre-diagnostic symptom duration. IDH1 codon 132 mutation and 1p/19q co-deletion constitutes an important genetic and molecular profile [6,7] The impact of these mutations on the clinical course of glioma has led to a change in WHO classification of low-grade gliomas in 2007 [8]. The role of Procarbazine Lomustine and Vincristine (PCV) chemotherapy is already established in terms of improving survival in low-grade glioma (LGG). This improved survival has led to the increasing administration of PCV to LGG patients over the past years. The purpose of this study was to evaluate the toxicity profile of PCV and its clinical relevance in our practice
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