Original Article

You have full text access to this OnlineOpen article

External beam irradiation and the combination of cisplatin and carmustine followed by carmustine alone for the treatment of high-grade glioma

A phase 2 Southwest Oncology Group trial

  1. Deborah T. Blumenthal MD1,2,
  2. Cathryn Rankin MS3,‡‡,*,
  3. Harmon J. Eyre MD4,
  4. Robert B. Livingston MD5,†,
  5. Alexander M. Spence MD5,‡,
  6. Keith J. Stelzer MD, PhD5,§,
  7. Elisabeth J. Rushing MD6,
  8. Mitchel S. Berger MD7,
  9. Saul E. Rivkin MD5,¶,
  10. Allen L. Cohn MD8,‖,
  11. Stephen H. Petersdorf MD5,††

Article first published online: 2 JUN 2008

DOI: 10.1002/cncr.23585

Issue

Cancer

Cancer

Volume 113, Issue 3, pages 559–565, 1 August 2008

Additional Information

How to Cite

Blumenthal, D. T., Rankin, C., Eyre, H. J., Livingston, R. B., Spence, A. M., Stelzer, K. J., Rushing, E. J., Berger, M. S., Rivkin, S. E., Cohn, A. L. and Petersdorf, S. H. (2008), External beam irradiation and the combination of cisplatin and carmustine followed by carmustine alone for the treatment of high-grade glioma. Cancer, 113: 559–565. doi: 10.1002/cncr.23585

Author Information

  1. 1

    Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute at the University of Utah Health Sciences Center, Salt Lake City, Utah

  2. 2

    Neuro-oncology Service, Oncology Division, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel

  3. 3

    Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington

  4. 4

    Research and Cancer Control Science, American Cancer Society, Atlanta, Georgia

  5. 5

    Puget Sound Oncology Consortium, Seattle, Washington

  6. 6

    Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC

  7. 7

    Department of Neurosurgery, University of California at San Francisco, San Francisco, California

  8. 8

    Division of Medical Oncology, University of Colorado Health Sciences Center, Denver, Colorado

  1. †

    Arizona Hemophilia and Thrombosis Center, Arizona Cancer Center, Hematology/Oncology Section, Tucson, Arizona

  2. ‡

    Department of Neurology, University of Washington School of Medicine, Seattle, Washington

  3. §

    Radiation Oncology, Mid-Columbia Medical Center, The Dalles, Oregon

  4. Swedish Cancer Institute, Seattle, Washington

  5. ‖

    Medical Oncology, Rocky Mountain Cancer Centers, Denver, Colorado

  6. ††

    Medical Oncology, Seattle Cancer Care Alliance, Seattle, Washington

  1. ‡‡

    Fax: (734) 998-7118

*Group Chair's Office, Southwest Oncology Group (SWOG-9016), 24 Frank Lloyd Wright Dr., PO Box 483, Ann Arbor, MI 48106-0483

Publication History

  1. Issue published online: 18 JUL 2008
  2. Article first published online: 2 JUN 2008
  3. Manuscript Accepted: 4 MAR 2008
  4. Manuscript Revised: 17 FEB 2008
  5. Manuscript Received: 10 DEC 2007

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (101K)

Keywords:

  • high‒grade glioma;
  • prognosis;
  • carmustine/cisplatin combination;
  • multimodality therapy;
  • Southwest Oncology Group

The Southwest Oncology Group evaluated carmustine and cisplatin in combination with external beam radiotherapy for the treatment of patients with high‒grade gliomas. Despite the presence of a cohort of long‒term survivors, the current study results do not suggest an improvement over treatment with radiotherapy and carmustine alone.

Abstract

BACKGROUND.

The poor prognosis reported for patients with high‒grade glial neoplasms indicates a need for the development of multimodality therapeutic approaches. The addition of chemotherapy has contributed variably to increased survival. The objective of the current study (Southwest Oncology Group [SWOG] 9016) was to determine whether concurrent radiotherapy and chemotherapy with the combination of carmustine and cisplatin could be given safely in a cooperative group setting. Additional objectives included the estimation of response rate, the rate of disease stabilization, and the probability of 1-year survival.

METHODS.

SWOG 9016 study included 59 eligible patients with grade III or IV astrocytoma who received radiotherapy concurrently with carmustine/cisplatin chemotherapy. Patients were required to have either measurable or evaluable disease. The therapeutic endpoints were comprised of complete response (CR), partial response (PR), or progressive disease (PD).

RESULTS.

Six patients achieved a CR (CR rate of 10%; 95% confidence interval [95% CI], 4–21%), 4 achieved a PR (PR rate of 7%; 95% CI, 2–16%), and 2 patients (3%) experienced an unconfirmed response. Twenty-four patients (41%; 95% CI, 28–54%) had stable disease and 10 patients (17%) demonstrated PD. The overall disease stabilization rate (CR + PR + stable disease, excluding unconfirmed response) was 58% (95% CI, 44–70%).

CONCLUSIONS.

Despite the presence of a cohort of long‒term survivors, the results of the current study do not appear to support the additional studyor routine use of concurrent cisplatin and carmustine. Cancer 2008. © 2008 American Cancer Society.

View Full Article (HTML) Get PDF (101K)