Phase I study of topotecan plus cranial radiation for glioblastoma multiforme: Results of Radiation Therapy Oncology Group Trial 9507

被引:41
作者
Fisher, BJ
Scott, C
Macdonald, DR
Coughlin, C
Curran, WJ
机构
[1] London Reg Canc Ctr, Dept Radiat Oncol, London, ON N6A 4L6, Canada
[2] London Reg Canc Ctr, Dept Med Oncol, London, ON N6A 4L6, Canada
[3] Univ Western Ontario, Dept Oncol, London, ON, Canada
[4] Univ Western Ontario, Dept Clin Neurol Sci, London, ON, Canada
[5] Radiat Oncol Headquarters, Philadelphia, PA USA
[6] Lahey Hitchcock Med Ctr, Dartmouth Hitchcock Med Ctr, Dept Radiat Oncol, Lebanon, NH USA
[7] TJ Univ Hosp Bodine, Ctr Canc Treatment, Dept Radiat Oncol, Philadelphia, PA USA
关键词
D O I
10.1200/JCO.2001.19.4.1111
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: A phase I trial was conducted by the Radiation Therapy Oncology Group (RTOG) to determine the maximum-tolerated dose of topotecan that could be safely combined with standard cranial radiation for glioblastoma multiforme. A secondary objective was to document the acute and late toxicities of this combination of chemotherapy and radiation. Patients and Methods: Forty-seven patients with histologically confirmed glioblastoma multiforme were entered onto this phase I trial. Three cycles of topotecan were administered at 21-day intervals commencing at day 1 of cranial radiotherapy (60 Gy/30 fractions). Each cycle consisted of daily 30-minute intravenous (IV) infusions for 5 days. The dose of tapotecan was escalated in three-dose increments from 0.5 mg/m(2)/d to 1.0 mg/m(2)/d to 1.5 mg/m(2)/d in different patient groups. Results: The majority of patients were over age 50. Three dose levels of topotecan were tested. Fifteen patients accrued to level 1 (topotecan dose 0.5 mg/m(2)/d). No grade 4 toxicities were seen. Sixteen patients accrued to level 2 (topotecan dose 1.0 mg/m(2)/d), five of whom had brief episodes of grade 4 neutropenia. Seventeen patients accrued to level 3 (1.5 mg/m(2)/d). Six of these patients had brief episodes of grade 4 neutropenia and four developed grade 3 thrombocytopenia. No serious nonhematologic or late toxicities were seen. Median survival for all patients was 9.7 months. There was no apparent difference in survival by topotecan dose schedule. Conclusion: Toxicity was acceptable at an IV topotecan dose of 1.5 mg/m(2)/d administered daily for 5 days every 21 days for three cycles. A phase II trial has been performed using this dose of topotecan.
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页码:1111 / 1117
页数:7
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