Journal of Clinical Oncology, Vol 15, 3427-3432, Copyright © 1997 by American Society of Clinical Oncology
Salvage chemotherapy with paclitaxel for recurrent oligodendrogliomas
MC Chamberlain and PA Kormanik
University of California, San Diego, La Jolla 92093-8421, USA. marc_chamberlain@cis.ucsd.edu
PURPOSE: A prospective phase II study of paclitaxel was performed in adult
patients with recurrent hemispheric oligodendrogliomas. PATIENTS AND
METHODS: Twenty adult patients (14 men and six women), ages 18 to 52 years
(median, 40.5), with recurrent supratentorial hemispheric
oligodendrogliomas were treated. All patients had previously been treated
with surgery, involved-field radiotherapy (median dose, 55 Gy; range 54 to
55 Gy) and nitrosourea-based (procarbazine, lomustine [CCNU], and
vincristine [PCV-3 regimen]) chemotherapy (median number of cycles, five;
range, four to six). Fourteen patients were treated adjuvantly with
radiotherapy and nitrosourea-based chemotherapy; six were treated at
recurrence following initial gross total resection with reoperation
(subtotal resection in all), radiotherapy, and nitrosourea- based
chemotherapy. Paclitaxel was administered intravenously at a dose of 175
mg/m2 every 3 to 4 weeks with neurologic and neuroradiographic evaluation
every 8 weeks. RESULTS: A median of three cycles of paclitaxel (range, two
to 10) were administered. All patients were assessable. Toxicity included
partial alopecia (12 patients), thrombocytopenia (six), neutropenia
(three), and anemia (one). One patient developed neutropenic fever without
bacteriologic documentation and four required transfusion of blood products
(RBCs, n = 2; platelet, n = 2). No treatment-related deaths occurred. Ten
patients (50%) demonstrated either a neuroradiographic partial response (n
= 3) or stable disease (n = 7), with a median response and stable disease
duration of 10 months (range, 5 to 14). CONCLUSION: Paclitaxel demonstrated
modest efficacy with minimal toxicity in this pretreated cohort of adult
patients with recurrent hemispheric oligodendrogliomas.
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