Article
Pattern of recurrence in patients with glioblastoma multiforme treated with an antiangiogenic therapy
Lokalisation der Rezidive von antiangiogen behandelten Patienten mit Glioblastoma multiforme
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Published: | May 4, 2005 |
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Outline
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Objective
Glioblastoma multiforme is the prototype of an angiogenic tumour and thus predestined for antiangiogenic therapy. But a possible escape mechanism of tumour cells is increased invasion. The aim of this study was to evaluate the progression free- and overall-survival in patients with glioblastoma multiforme treated with continuous low dose chemotherapy with temozolomide and rofecoxib with special respect to the localisation of tumour recurrence.
Methods
22 Patients with glioblastoma multiforme received after operation and radiation therapy continuous low dose chemotherapy with temozolomide (up to 20mg/m2) and the COX-II inhibitor rofecoxib. Clinical and MRI follow-up examination was done every 8 weeks. Mean follow-up time was 20 months. Tumour tissue was analysed for microvessel density, COX-II expression and VEGF expression in 13 patients.
Results
Mean progression-free survival of all patients was 9.7 months, mean overall survival was 16.9 months. 14 out of 22 Patients (67%) suffered a tumour recurrence distant to the original tumour-localisation. These patients had a slightly shorter overall survival. Patients with a higher microvessel density responded significantly better to the therapy (PFS 11.7 vs. 6.7 months). There was no relationship of the immunhistochemical markers and the incidence of distant tumour recurrence.
Conclusions
Despite the dramatic increase in distant tumour recurrences compared to historical controls the continuous low dose chemotherapy seems to be a promising therapy option in highly vascularised glioblastoma since the progression-free survival and the overall survival compare very well to actual studies.