A retrospective study of the value of chemotherapy as adjuvant therapy to surgery and radiotherapy in grade 3 and 4 gliomas

Gundersen, S.; Lote, Knut; Watne, Kjell

doi:10.1016/s0959-8049(98)00146-4

Cited by 12 publications

(9 citation statements)

References 16 publications

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“…This retrospective analysis did not suggest any survival benefit for PCV. The influence of selection factors on recent results of a retrospective study in 85 patients with anaplastic astrocytoma (age < 55 years), which showed a favorable median survival of 80 months (intra-arterial BCNU, procarbazine, vincristine) vs 25 months (no chemotherapy), is not entirely clear [24]. So far, superiority of combination PCV or BCNU-PV has not been confirmed in a prospective study designed specifically to address this issue.…”

Section: Level-3 Evidencementioning

confidence: 99%

A Review of Current and Future Treatment Strategies for Malignant Astrocytomas in Adults

Nieder

Nestle

2000

Strahlentherapie und Onkologie

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Section: Level-3 Evidencementioning

confidence: 99%

A Review of Current and Future Treatment Strategies for Malignant Astrocytomas in Adults

Nieder

Nestle

2000

Strahlentherapie und Onkologie

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“…delivery, the results of clinical trials of i.a. chemotherapy in brain tumors show minimal, if any, improvement in survival (Dropcho et al, 1998;Gundersen et al, 1998;Hirano et al, 1998).…”

Section: Intra-arterial Administrationmentioning

confidence: 99%

The blood-brain and blood-tumor barriers: A review of strategies for increasing drug delivery

Groothuis¹

2000

Neuro-Oncol

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Drug delivery to brain tumors has been a controversial subject. Some believe the blood-brain barrier is not important, while others believe it is the major obstacle in treatment and have devised innovative approaches to circumvent it. These approaches can be divided into two categories: those that attempt to increase drug delivery of intravascularly administered drugs by manipulating either the drugs or capillary permeability, and those that attempt to increase drug delivery by local administration. Several strategies have been developed to increase the fraction of intravascular drug reaching the tumor, including intraarterial administration, barrier disruption, new ways of packaging drugs, and, most recently, inhibiting drug ef ux from tumor. When given intravascularly, all drugs have a common drawback: the body acts as a sink, and, even in the best situations, only a small fraction of administered drug actually reaches the tumor. A consequence is that systemic toxicity is usually the dose-limiting factor. When given locally, such as into the cerebrospinal uid or directly into the tumor, 100% of an administered dose is delivered to the target site. However, local delivery is associated with variable and unpredictable spatial distribution and variation in drug concentration. The major dose-limiting factor of most local delivery methods will be neurotoxicity. The relative advantages and disadvantages of the different methods of circumventing the blood-brain barrier are presented in this review, and special attention is given to convection-enhanced delivery, which has particular promise for the local delivery of large therapeutic agents such as monoclonal antibodies, antisense oligonucleotides, or viral vectors. Neuro-Oncology 2, 45-59, 2000 (Posted to Neuro-Oncology [serial online], Doc. 99-30, December 14, 1999 IntroductionThe delivery of drugs to brain tumors has long been a controversial problem. In 1977, Vick et al. wrote in an editorial: "We believe that there is compelling evidence to suggest that the 'blood-brain barrier,' as it is generally conceived, is not one of the factors impeding the success of brain tumor chemotherapy." They went on to say that "dosage, route of administration, tumor cell uptake, metabolic fate within tumor cells, and the washout or sink effect of the extracellular space and CSF are the issues that will have to be studied" (Vick et al., 1977). Some clinicians have agreed with Vick et al. (Donelli et al., 1992;Stewart, 1994); however, on the whole, the belief that the BBB 3 and BTB prevent drugs from reaching brain tumors in suf cient concentrations to kill the tumor cells has motivated numerous attempts to increase the amount of drug that reaches the tumor. Many innovative methods have been used to try to increase drug delivery including, most recently, a method in which drugs are infused directly into brain tumors, a method referred to as convection-enhanced delivery (CED) Laske et al., 1997a;Lieberman et al., 1995). This review Neuro-Oncology n J AN UA RY 2 0 00 45Neuro-Oncology

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“…This was followed by RT and adjuvant chemotherapy with carmustine [7]. Since 2005, however, the standard treatment for patients with newly diagnosed GBM has consisted of surgery, RT plus concurrent TMZ followed by six cycles of adjuvant TMZ, a regimen that was found to improve survival appreciably when compared with RT alone [1].…”

Section: Discussionmentioning

confidence: 99%

Long-term survival with unmethylated MGMT glioblastoma multiforme

Savva-Bordalo¹,

Soares²,

Rocha³

et al. 2011

IJCRI

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Introduction: Glioblastoma multiforme is the most aggressive tumor of the central nervous system. Despite advances in its management, overall prognosis remains poor, with a median survival time of less than one year. Good response to chemotherapy with temozolomide (TMZ) is usually associated with methylation of the promoter of the O(6)-methylguanine-DNA methyltransferase (MGMT) gene. Case Report: We describe here a patient with glioblastoma multiforme, who had good prognostic clinical features, age and performance status, but unmethylated MGMT promoter and who survived for eight years while treated with a multi-modal approach. Conclusion: Good response to treatment, despite the absence of MGMT hypermethylation, suggests that other genetic or molecular factors may predict prognosis and therapeutic response in patients with glioblastoma multiforme.

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A retrospective study of the value of chemotherapy as adjuvant therapy to surgery and radiotherapy in grade 3 and 4 gliomas

Cited by 12 publications

References 16 publications

A Review of Current and Future Treatment Strategies for Malignant Astrocytomas in Adults

A Review of Current and Future Treatment Strategies for Malignant Astrocytomas in Adults

The blood-brain and blood-tumor barriers: A review of strategies for increasing drug delivery

Long-term survival with unmethylated MGMT glioblastoma multiforme

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