Survival with dacarbazine and fotemustine in newly diagnosed glioblastoma multiforme

Br J Cancer. 2003 Feb 24;88(4):496-501. doi: 10.1038/sj.bjc.6600769.

Abstract

A total of 55 patients with histologically proven glioblastoma multiforme (total gross resection: n=24, subtotal resection: n=20, stereotactic biopsy: n=11) were treated with the combination of dacarbazine (D) (200 mg m(-2)) and fotemustine (F) (100 mg m(-2)) and concomitant radiotherapy (2 Gy day(-1), 5 days per week using limited fields up to 60 Gy) to assess efficacy and toxicity of this regimen. Survival (median survival, 12-, 18- and 24-month survival rates) and time to progression (median time to progression (TTP), 6-month progression-free survival) were analysed by Kaplan-Meier's method. A total of 268 (range 1-8, median: 5) cycles were administered. Median survival is 14.5+ (range: 0.5-40+) months, and the 12-, 18- and 24-month survival rates are 58, 29 and 23%, respectively. Median TTP from the start of D/F therapy is 9.5+ (range: 0.5-33+) months. The 6-month progression-free survival is 54%. Partial remissions were observed in 3.6%. Main toxicity was thrombocytopenia. Five patients were excluded from further D/F application, four patients because of prolonged thrombocytopenia NCI-CTC grades 3 and 4 and one patient because of whole body erythrodermia. One patient died because of septic fever during thrombocytopenia and leukopenia NCI-CTC grade 4 after the first cycle. No other toxicities of NCI-CTC grade 3 or 4 occurred. The treatment is feasible in a complete outpatient setting and the results of the D/F regimen justify further investigations with these compounds.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Dacarbazine / adverse effects*
  • Dacarbazine / therapeutic use*
  • Disease Progression
  • Female
  • Glioblastoma / diagnosis*
  • Glioblastoma / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Nitrosourea Compounds / adverse effects*
  • Nitrosourea Compounds / therapeutic use*
  • Organophosphorus Compounds / adverse effects*
  • Organophosphorus Compounds / therapeutic use*
  • Survival Analysis
  • Survival Rate

Substances

  • Nitrosourea Compounds
  • Organophosphorus Compounds
  • Dacarbazine
  • fotemustine