© 2001 by Society
© 2001 by the Society forNeuro-Oncology
Interferon-
2a and 13-cis-retinoic acid with radiationtreatment for high-grade glioma
Hoag Cancer Center, Newport Beach, CA 92658 (R.O.D.,M.S., K.M., N.M.B.); Bloomington Hospital,Bloomington, IN 47402 (D.F.T., B.R.K., M.M.P.); Central Office of the Cancer Biotherapy Research GroupFranklin, TN 37068 (C.K.C., C.D.)
3 Address correspondence and reprint requests to Robert O. Dillman, MedicalDirector, Hoag Cancer Center, One Hoag Drive, Building 41, Newport Beach, CA92658.
 |
Abstract |
|---|
Interferon-
(IFN-) has been safely given concurrently with radiationtherapy (RT) in treating gliomas. As single agents, both IFN- andcis-retinoic acid (CRA) have produced objective tumor regressions inpatients with recurrent gliomas. In vitro, IFN-2a and CRA enhanceradiation therapy effects on glioblastoma cells more than either agent alone.This trial was conducted to determine the clinical effects of IFN-2aand CRA when given concurrently with radiation therapy to patients withhigh-grade glioma. Newly diagnosed patients with high-grade glioma receivedIFN-2a at a dosage of 3 to 6 million IU s.c. 4 times a day for 3 daysper week and 1 mg/kg CRA by mouth 4 times a day for 5 days per week during thedelivery of partial brain radiation therapy at 180 cGy x 33 fractionsfor 5 days per week for a total of 59.4 Gy during the 7-week period. Use ofthe antiepileptic phenytoin was prohibited after observing that thecombination of IFN-2a, CRA, and phenytoin was associated with a highrate of dermatologic toxicity not seen in a previous study with concurrentIFN-2a and radiation therapy. Forty patients (26 men and 14 women) witha median age of 60 (range, 19 to 81 years) were enrolled between August 1996and October 1998. Histopathologic diagnoses were glioblastoma multiforme orgrade 4 anaplastic astrocytoma in 36 patients, and grade 3 anaplasticastrocytoma in 4 patients. Only 4 patients (10%) underwent a gross totalresection of tumor prior to this therapy; 50% were asymptomatic when treatmentwas initiated. The planned 7-week course of concurrent therapy was completedby 75% of patients; 30% completed the 16-week course of IFN- and CRAalone. At a median follow-up of 36 months, there were 37 deaths, with a medianoverall survival of 9.3 months and a 1-year survival rate of 42%. There was noimprovement in survival compared with a similar group of 19 patients treatedwith concurrent IFN-2a and radiation therapy in a previous trial. Inthe highrisk group of patients in the present study, concurrent treatment withIFN-2a, CRA, and RT was feasible, but was not associated with a betteroutcome compared with a similar patient population treated with radiationtherapy and IFN-2a, or compared with radiation therapy alone in othertrials.
Received June 15, 2000; Accepted August 9, 2000
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  K. A. Jaeckle, K. R. Hess, W.K. A. Yung, H. Greenberg, H. Fine, D. Schiff, I. F. Pollack, J. Kuhn, K. Fink, M. Mehta, et al. Phase II Evaluation of Temozolomide and 13-cis-Retinoic Acid for the Treatment of Recurrent and Progressive Malignant Glioma: A North American Brain Tumor Consortium Study J. Clin. Oncol., June 15, 2003; 21(12): 2305 - 2311. [Abstract] [Full Text] [PDF]
|
|