High-dose BCNU and autologous progenitor cell transplantation given with intra-arterial cisplatinum and simultaneous radiotherapy in the treatment of high-grade gliomas: benefit for selected patients.

摘要: A phase II study of postoperative high-dose carmustine (HDBCNU), intracarotid cisplatin (CDDP), and radical radiotherapy in patients with high-grade glioma was performed. Patients underwent 4-6 consecutive days blood hematopoietic progenitor cell (HPC) apheresis without prior mobilization. Chemotherapy included CDDP, 60 mg/m2, BCNU, 900 mg/m2. HPC were infused 48 h after HDBCNU. Whole brain irradiation, up to 50 Gy, started on the 8th day infusion. With a median follow-up time 44 months, overall survival 15.5 months. Eight (23.5%) are alive free disease 2-6 years treatment (seven out 25 glioblastoma multiforme one nine anaplastic astrocytoma). Survival influenced by young age, good performance complete surgical resection. Two (5.8%) died therapy-related complications. Acute hematological toxicity HDBCNU moderate, full recovery 26. No acute pulmonary or hepatic found. Late severe neurological observed third surviving beyond 2 years. We conclude that HDBCNU, CDDP appear benefit some gliomas, III studies should preferentially select resectable tumors.