Fountzilas G, Karavelis A, Makrantonakis P, Selviaridis P, Tzitzikas J, Kalogera-Fountzila A, Hatzibaloglou A, Karkavelas G, Foroglou G, Tourkantonis A
Department of Internal Medicine, Aristotle University, Thessaloniki, Macedonia, Greece.
Am J Clin Oncol. 1997 Apr;20(2):138-42. doi: 10.1097/00000421-199704000-00006.
Twenty-two patients with supratentorial malignant gliomas were treated postoperatively with concurrent intracarotid chemotherapy and radiation therapy. There were seven women and 15 men with a median age of 56 years (range, 22-69) and median performance status (Karnofsky score) of 70 (range, 40-90). In all except two cases, histologic studies confirmed malignant glioma. All patients were irradiated with a cobalt 60 equipment. They should have received 45 Gy to the whole brain plus a 15-Gy coned-down boost to the tumor area. Chemotherapy consisted of cisplatin infusion at a dose of 60 mg/m2 on days 2, 22, and 42. Treatment was interrupted in two patients because of progressive disease and voluntary withdrawal in one patient each. In all, 63 courses of cisplatin infusion were administered, all at full dose. Two patients achieved a partial response, and nine had stable disease. Toxicities included nausea/vomiting in nine patients (41%) and transient hemiparesis, confusion, diarrhea, and thrombophlebitis in one patient each. Median time to progression was 26 weeks (range, 4-226+), and median survival was 58 weeks (range, 14-226+). In conclusion, the present study suggests that intracarotid cisplatin administered concurrently with radiation does not improve the therapeutic index in malignant gliomas.
22例幕上恶性胶质瘤患者术后接受了颈内动脉化疗和放射治疗。其中女性7例，男性15例，中位年龄56岁（范围22 - 69岁），中位体能状态（卡诺夫斯基评分）为70分（范围40 - 90分）。除2例患者外，组织学研究均证实为恶性胶质瘤。所有患者均使用钴60设备进行放疗。他们应接受全脑45 Gy照射，外加对肿瘤区域15 Gy的缩野加量照射。化疗方案为在第2、22和42天静脉输注顺铂，剂量为60 mg/m²。2例患者因疾病进展中断治疗，各有1例患者自愿退出治疗。总共进行了63个疗程的顺铂输注，均为全剂量。2例患者达到部分缓解，9例病情稳定。毒性反应包括9例患者（41%）出现恶心/呕吐，各有1例患者出现短暂性偏瘫、意识模糊、腹泻和血栓性静脉炎。中位进展时间为26周（范围4 - 226 +），中位生存期为58周（范围14 - 226 +）。总之，本研究表明，颈内动脉给予顺铂并同时进行放疗并不能提高恶性胶质瘤的治疗指数。
