Response and progression in recurrent malignant glioma

Neuro Oncol. 1999 Oct;1(4):282-8. doi: 10.1093/neuonc/1.4.282.

Abstract

In this article we report the results of a study of the relationship between response and progression in 375 patients with recurrent glioma enrolled in phase II chemotherapy trials. We reviewed the records of patients from 8 consecutive phase II trials, including 225 patients with recurrent glioblastoma multiforme and 150 with recurrent anaplastic astrocytoma. Median age was 45 years (range, 15-82) and median Karnofsky performance score was 80 (range, 60-100). Forty-one patients (11%) had more than two prior resections and/or more than two prior chemotherapy regimens. Best response was complete (n = 1) or partial (n = 33) in 34 patients (9%). Median time to response was 14 weeks, and median response duration was 44 weeks. Simon-Makuch estimates for 52-week progression-free survival for patients progression-free at 13 weeks were 48% for response and 28% for nonresponse. When response was treated as a time-dependent covariate in a Cox proportional hazards regression analysis, response was associated with significantly lower failure rates (hazard ratio 0.5; 95% confidence interval 0.3-0.8; P = 0.0016). This study showed that response in recurrent glioma is associated with a significant reduction in progression rates.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Actuarial Analysis
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alitretinoin
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Astrocytoma / drug therapy
  • Astrocytoma / mortality
  • Astrocytoma / radiotherapy
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / mortality
  • Brain Neoplasms / radiotherapy
  • Carboplatin / administration & dosage
  • Combined Modality Therapy
  • Disease Progression
  • Disease-Free Survival
  • Eflornithine / administration & dosage
  • Female
  • Fluorouracil / administration & dosage
  • Glioblastoma / drug therapy
  • Glioblastoma / mortality
  • Glioblastoma / radiotherapy
  • Glioma / drug therapy*
  • Glioma / mortality
  • Glioma / radiotherapy
  • Humans
  • Interferon-beta / administration & dosage
  • Male
  • Menogaril / administration & dosage
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / mortality
  • Procarbazine / administration & dosage
  • Prognosis
  • Proportional Hazards Models
  • Texas / epidemiology
  • Treatment Outcome
  • Tretinoin / administration & dosage

Substances

  • Alitretinoin
  • Procarbazine
  • Tretinoin
  • Interferon-beta
  • Menogaril
  • Carboplatin
  • Fluorouracil
  • Eflornithine