56. Reoperation and loco-regional chemotherapy improve survival in glioblastoma patients

We scheduled a protocol by combining both local bleomycin and mitoxantrone in addition to systemic chemotherapy in 54 primary GBM selected pts. According to our eligibility requirements. Moreover 15 pts underwent a second surgery. l) BCNU 100 mg/m ² + CDDP 90 mg/m ² I.V. for 5 times 2) bleomycin 0,75 mg in 2 cc of physiological solution days 1-2-3 and mitoxantrone 3 mg day 4 trough Ommaya every 20 days. 3) At recurrence all patients received PVC every 6 weeks. Drugs interstitially delivered by-pass the blood-brain-barrier and can achieve higher and more prolonged concentrations into the tumor area. There was no evidence of increased brain toxicity from the local delivery of bleomycin and mitoxantrone. The whole group of pts. (54), those treated with locoregional chemotherapy (25) and 15 pts reoperated on had 23.1; 26,5 and 27,6 mos ST respectively. Our present findings emphasize the safety and effectiveness of loco- regional chemotherapy as noted in the literature. Extensive surgery could be justifiable if it is a part of the whole program of treatment. We feel confident that the addition of intratumoral chemotherapy was effective and was a determining factor in association with a second tumor resection in the prolongation of ST in our selected patients.