The combination of carmustine wafers and fotemustine in recurrent glioblastoma patients: a monoinstitutional experience

Biomed Res Int. 2014:2014:678191. doi: 10.1155/2014/678191. Epub 2014 Apr 9.

Abstract

Background: To date, there is no standard treatment for recurrent glioblastoma. We analyzed the feasibility of second surgery plus carmustine wafers followed by intravenous fotemustine.

Methods: Retrospectively, we analyzed patients with recurrent glioblastoma treated with this multimodal strategy.

Results: Twenty-four patients were analyzed. The median age was 53.6; all patients had KPS between 90 and 100; 19 patients (79%) performed a gross total resection > 98% and 5 (21%) a gross total resection > 90%. The median progression-free survival from second surgery was 6 months (95% CI 3.9-8.05) and the median OS was 14 months (95% CI 11.1-16.8 months). Toxicity was predominantly haematological: 5 patients (21%) experienced grade 3-4 thrombocytopenia and 3 patients (12%) grade 3-4 leukopenia.

Conclusion: This multimodal strategy may be feasible in patients with recurrent glioblastoma, in particular, for patients in good clinical conditions.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brain Neoplasms / drug therapy*
  • Carmustine / adverse effects
  • Carmustine / therapeutic use*
  • Disease-Free Survival
  • Female
  • Glioblastoma / drug therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Nitrosourea Compounds / adverse effects
  • Nitrosourea Compounds / therapeutic use*
  • Organophosphorus Compounds / adverse effects
  • Organophosphorus Compounds / therapeutic use*

Substances

  • Nitrosourea Compounds
  • Organophosphorus Compounds
  • fotemustine
  • Carmustine