A phase II study of radiotherapy after hyperbaric oxygenation combined with interferon-beta and nimustine hydrochloride to treat supratentorial malignant gliomas.

Abstract

Hypoxic cells play a key role in the radioresistance of malignant glioma. Interferon-beta, ACNU as nimustine hydrochloride and radiotherapy (IAR) is a common therapy for malignant glioma in Japan. Since hyperbaric oxygenation (HBO) increases oxygen pressure in glioma tissue, we applied a modified IAR therapy, radiotherapy after HBO combined with interferon-beta and ACNU (HBO/IAR therapy), for supratentorial malignant gliomas. Daily radiation therapy was completed within 15 min after HBO. We assessed HBO/IAR with respect to toxicity, response rates and the time of tumor progression (TTP). We also examined the incidence of responses by some prognostic factors before HBO/IAR, namely, age, Karnofsky performance scale (KPS), histological type, tumor size, tumor site and operation type. Of 39 patients who participated in this study, 35 underwent a complete schedule of HBO/IAR therapy in which toxicity was permissible. Thirty patients (76.9%) either maintained or increased KPS during HBO/IAR with a mean duration of 68 +/- 14 days. The response rates (CR + PR%) for glioblastoma, anaplastic astrocytoma and overall were 50%, 30% and 43%, respectively. The incidence of therapeutic responses among all prognostic factors before HBO/IAR did not significantly differ. Median TTP for patients with glioblastoma, patients with anaplastic astrocytoma, and overall were 38, 56 and 43 weeks, respectively. The present study suggested that HBO/IAR therapy could be applied to especially patients with poor prognostic factors, because of its short treatment period, its permissible toxicity and identical response to patients with good prognostic factors.

• Authors: Takaaki Beppu, Katsura Kamada, Ryuji Nakamura, Hiroshi Oikawa, Masaru Takeda, Takeshi Fukuda, Hiroshi Arai, Kuniaki Ogasawara, Akira Ogawa
• Journal: Journal of neuro-oncology (J Neurooncol) Vol. 61 Issue 2 Pg. 161-70 (Jan 2003) ISSN: 0167-594X [Print] United States
• PMID: 12622455 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Nimustine
• Interferon-beta

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Brain Neoplasms (drug therapy, radiotherapy, therapy)
• Combined Modality Therapy
• Female
• Glioma (drug therapy, radiotherapy, therapy)
• Humans
• Hyperbaric Oxygenation
• Interferon-beta (administration & dosage)
• Magnetic Resonance Imaging
• Male
• Maximum Tolerated Dose
• Middle Aged
• Nimustine (administration & dosage)
• Radiotherapy Dosage
• Survival Rate