11. Intra-arterial carboplatin and etoposide in the treatment of malignant gliomas and brain métastases

M. Ceroni, J. Karau, F. Imbesi, C. Uggetti, M. G. Egitto, K. Marinu-Aktipi, F. Simonetti, P. Pergami, E. Giombelli, E. Benericetti, F. Zappoli

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Abstract

Thirty-seven patients, 23 with glioblastoma multiforme, 4 with anaplastic astrocytoma, 6 with astrocytoma with areas of GBL, 2 with gliosarcoma, 2 with a unique metastasis of epitelial carcinoma, received intra-arterial infusions of carboplatin and etoposide at a median dose of 600 mg and 200 mg respectively. Courses were repeated at 3-week intervals for a minimum of 3 and a maximum of 9 courses. Patients were subjected to over 150 courses of treatment. Hematological and hepatic tolerance was excellent (4 cases of asymptomatic transient thrombocytopenia, 1 case of transient leucopenia, 4 cases of slight anemia and a transient increase of hepatic enzymes in 6 cases). No other signs of neurological or systemic toxicity were detected. Selective intra-arterial catheterization of internal carotid or vertebral arteries using the femoral route was well tolerated. All patients were subjected to baseline MR scans with and without Gd-DTPA, which were repeated before every subsequent course. Response to treatment was based on evaluation of MR scans, applying Macdonald's criteria. No GBL or gliosarcoma case had complete or partial response, 13 had stable disease and 12 had progressive disease. Of 4 patients with anaplastic astrocytoma 3 had partial response and all had prolonged stable disease; of 6 astrocytomas with areas of GBL 4 had stable disease and 2 had progressive disease; one patient with brain metastasis has been free from disease for 3 years, the other has stable disease. Intra-arterial administration of carboplatin and etoposide is a safe well tolerated treatment with no toxicity; has scarce effect on GBL and gliosarcoma and we do not recommend a phase III study. The protocol will be continued in anaplastic astrocytoma, astrocytoma with areas of GBL and brain metastases. Serial MR imaging is an accurate method to assess chemotherapy effectiveness on tumor mass reduction and provides useful hints on treatment effectiveness in phase II studies.

Original languageEnglish
Pages (from-to)244
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume18
Issue number4
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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