Purpose: To evaluate activity and toxicity of simultaneous ACNU and Ara-C with concurrent accelerated hyperfractionated radiotherapy in the treatment of high-grade glioma.
Patients And Methods: Thirty patients aged 23-71 years (median 47.5), 16 patients with glioblastoma multiforme (GBM) and 14 patients with grade-III glioma, received 93 courses of ACNU/Ara-C (median 4 courses) at following dose levels (ACNU/Ara-C in mg/m2/day): 70/90 (11 courses), 75/100 (36 courses) and 90/120 (46 courses). ACNU was administered IV on day 1 of each cycle, Ara-C as a 2 h-intravenous infusion on days 1-3. Patients received concomitant radiation therapy with 2 daily fractions of 1.75 Gy up to 57 Gy (median).
Results: Median survival of all patients was 13 months, 11 months for GBM and > 28 months for grade-III glioma; 31% (9 patients) survived longer than 24 months. The percentage of grade IV hematological toxicity was dose-dependent: 33% at the 70/90 dose level, 40% at 75/100 and 58% at 90/120. Six patients required platelet transfusion, 1 patient red blood cells; no febrile neutropenia occurred. Among 18 patients evaluable for response, 3 (17%) showed PR, 8 (44%) NC and 7 (39%) PD at completion of chemoradiation. No acute or late neurological toxicity occurred in this study. Younger age (p = 0.0001) and grade-III histology (p = 0.0009) were important prognostic factors for prolonged survival.
Conclusion: This chemoradiation regimen is active in malignant gliomas and can be safely recommended at a dose level using 70 mg/m2 ACNU together with 90 mg/m2 Ara-C.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1023/a:1006498525605 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Aim: Successful deep brain stimulation (DBS) requires precise electrode placement. However, brain shift from loss of cerebrospinal fluid or pneumocephalus still affects aim accuracy. Multidetector computed tomography (MDCT) provides absolute spatial sensitivity, and intraoperative cone-beam computed tomography (iCBCT) has become increasingly used in DBS procedures.
View Article and Find Full Text PDFBrachial Artery Access for Carotid Artery Stenting: A Pooled Analysis.
Turk Neurosurg
June 2024
Faculty of Medicine, Federal University of Rio de Janeiro.
Introduction In the realm of Carotid Artery Stenting (CAS), various access methods such as Transfemoral access (TFA), Transradial Artery access (TRA), and Transbrachial access (TBA) have been employed. While TFA is widely established, TRA and TBA offer alternative options. TBA lacks comprehensive studies, and there is a notable lack of comprehensive evidence systematically evaluating its outcomes.
View Article and Find Full Text PDFEvaluation of Postoperative Prognosis on Carotid Endarterectomy Single Center Experience.
Turk Neurosurg
May 2024
ankara universty.
Aim: Ischemic stroke remains one of the leading causes of death and disability worldwide and ca-rotid stenosis is the leading etiology of ischemic strokes of non-cardiac origin. The chronic inflammatory process and pro-inflammatory state in carotid stenosis seem to be the most im-portant underlying factor in carotid occlusion. In addition to medical therapy and carotid ar-tery stunting (CAS) in the treatment of carotid stenosis, carotid endarterectomy (CEA) is the main surgical treatment of carotid stenosis and its prognosis is the main subject of our study.
View Article and Find Full Text PDFAim: To assess the changes of intracranial pressure waveforms (ICPW) acquired noninvasively in a set of acute hydrocephalus patients prior to and posterior to interventions.
Material And Methods: Patients with clinical and radiological diagnoses of hydrocephalus were evaluated for alterations in ICPW by means of a system that detects cranial micro expansions just before and immediately after interventions. The system quantified the difference between ICPW peaks (P1 and P2), providing the P2/P1 ratio.
RELATIONSHIP BETWEEN DEFECTVOLUME AND COMORBID PATHOLOGIES IN PATIENTS UNDERGOING SURGERY FOR MYELOMENINGOCELE.
Turk Neurosurg
May 2024
Sincan Eğitim ve Araştırma Hastanesi.
Aim: The aim of the study is to determine sac volume based on radiological examinations in patients undergoing surgery for myelomeningocele (MMC) and to investigate the relationship of sac volume with hydrocephalus and Chiari malformation type 2 (CM) with a view to determining the optimum length of follow-up and recommend a treatment plan.
Material And Methods: The present study involved the retrospective review of radiologic examinations and medical files of 81 patients who underwent surgery for myelomeningocele between 2015 and 2022 in the neurosurgery clinic of Ankara Training and Research Hospital. Then, MMC sac volumes were measured and the statistical relationship of these measurements with the Evans Index, progressive enlargement of the ventricles after sac repair and CM was investigated.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!