Regional Therapy of High Grade Astrocytomas

Manzione, James V.; Madajewicz, Stefan; Roque, Cassiano Garcia; Roche, Patricia; Arafat, Tfayli; Shindo, Maisie L.

doi:10.1055/s-2008-1057029

Semin intervent Radiol

1998

DOI: 10.1055/s-2008-1057029

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Regional Therapy of High Grade Astrocytomas

James V. Manzione

Stefan Madajewicz

Cassiano Garcia Roque

et al.

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“…One major obstacle in the therapy of brain tumors is the ability to deliver effective chemotherapy to the tumor due to the impermeability of the blood‐brain barrier to the majority of chemotherapeutic agents 3. Hence, there has been an increased interest in the regional treatment of high grade astrocytomas, including interstitial therapy, polymer‐mediated interstitial delivery, and intraarterial chemotherapy 4…”

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Therapy for patients with high grade astrocytoma using intraarterial chemotherapy and radiation therapy

Madajewicz

Chowhan

Arafat

et al. 2000

Cancer

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BACKGROUND High grade astrocytomas account for approximately 40% of all primary brain tumors. The median survival is approximately 8–10 months for patients with glioblastoma multiforme and 36 months for patients with anaplastic astrocytoma. The results of systemic chemotherapy in the treatment of brain tumors have been reported to be less than satisfactory, mainly because of the blood‐brain barrier impermeability for chemotherapeutic drugs. Intraarterial chemotherapy has been an attractive alternative with which to overcome this problem. METHODS Eighty‐three patients with high grade astrocytoma (glioblastoma multiforme [63 patients] and anaplastic astrocytoma –[20 patients]) were treated with intraarterial (intracarotid and/or intravertebral) chemotherapy and radiation therapy between 1987 and 1997. Patients received cisplatin, 60 mg/m2, and etoposide, 40 mg/m2. Radiation therapy was delivered either after completion of the chemotherapy or concomitantly with the chemotherapy. RESULTS Thirty‐four of 71 evaluable patients with high grade astrocytoma (48%) responded to the chemotherapy. The median survival for patients with glioblastoma multiforme who received chemotherapy prior to radiation therapy was 20 months versus 7 months for those patients who underwent concomitant chemotherapy/radiation therapy. Patients with anaplastic astrocytoma who received chemotherapy prior to radiation therapy had a median survival of 45 months compared with 12 months for patients who received concomitant chemotherapy/radiation therapy. The toxicity profile has been reported to be mild and well tolerated. CONCLUSIONS Intraarterial chemotherapy for patients with glioblastoma multiforme, delivered prior to radiation therapy, appears to result in a median survival three times longer than that achieved with concomitant chemotherapy/radiation therapy. In addition, patients appear to survive substantially longer than they do after radiation therapy with the addition of systemic chemotherapy. Side effects are reported to be acceptable. Cancer 2000;88:2350–6. © 2000 American Cancer Society.

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confidence: 99%

Therapy for patients with high grade astrocytoma using intraarterial chemotherapy and radiation therapy

Madajewicz

Chowhan

Arafat

et al. 2000

Cancer

Self Cite

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Glioblastoma multiforme: advances in postsurgical management

Mohin¹,

Madajewicz²,

Manzione³

et al. 2006

Community Oncology

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Regional Therapy of High Grade Astrocytomas

Cited by 2 publications

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Therapy for patients with high grade astrocytoma using intraarterial chemotherapy and radiation therapy

Therapy for patients with high grade astrocytoma using intraarterial chemotherapy and radiation therapy

Glioblastoma multiforme: advances in postsurgical management

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