Cisplacel drug in combined and complex treatment of patients with high-grade (III–IV) brain gliomas
Keywords:high-grade (III–IV) brain gliomas, surgical treatment, local intraoperative chemotherapy, Cisplacel
Purpose. To estimate efficacy of intraoperative local chemotherapy with drug Cisplcel in the combined and complex treatment of patients with high-grade (III–IV) brain gliomas.
Materials and methods. 114 patients were included in the study, combined or complex treatment was conducted; in 57 patients at surgery performing in the bed of the tumor after it’s removal Cisplacel — a drug for intraoperative chemotherapy was implanted; in 57 — local chemotherapy was not used.
Results. In patients aged 50 years and younger after radical or subtotal removal of high-grade brain glioma Cisplacel application significantly increased the median survival from 14 to 21 months; 1-, 3- and 5-year survival rates — respectively from (67.6±10.1), (12.1±7.9) and (12,1±7.9)% to (90.9±6.1), (25.3±10,9) and (16.8±10,0)% (p=0.048). In patients older than 50 years, significant differences in survival rates were not identified.
Conclusions. 1. Cisplacel including in the scheme of combined and complex treatment of patients aged 50 years and younger with high-grade brain glioma after it’s radical or subtotal removal significantly increased the median survival and 1-, 3- and 5-year survival rates (p=0.048).
2. Justification of indications for Cisplacel use in other patients needs further study and careful analysis and estimation of prognostic factors affecting treatment outcomes.
Laperriere N, Zuraw L, Cairncross G. Radiotherapy for newly diagnosed malignant glioma in adults: a systematic review. Radiotherapy and Oncology. 2002;64(3):259-273. CrossRef
Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, Ludwin SK, Allgeier A, Fisher B, Belanger K, Hau P, Brandes AA, Gijtenbeek J, Marosi C, Vecht CJ, Mokhtari K, Wesseling P, Villa S, Eisenhauer E, Gorlia T, Weller M, Lacombe D, Cairncross JG, Mirimanoff RO. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. The Lancet Oncology. 2009;10(5):459-466. CrossRef
Chan JL, Lee SW, Fraass BA, Normolle DP, Greenberg HS, Junck LR, Gebarski SS, Sandler HM. Survival and Failure Patterns of High-Grade Gliomas After Three-Dimensional Conformal Radiotherapy. Journal of Clinical Oncology. 2002;20(6):1635-1642. CrossRef
Westphal M, Ram Z, Riddle V, Hilt D, Bortey E. Gliadel® wafer in initial surgery for malignant glioma: long-term follow-up of a multicenter controlled trial. Acta Neurochir (Wien). 2006;148(3):269-275. CrossRef
Affronti ML, Heery CR, Herndon JE 2nd, Rich JN, Reardon DA, Desjardins A, Vredenburgh JJ, Friedman AH, Bigner DD, Friedman HS. Overall survival of newly diagnosed glioblastoma patients receiving carmustine wafers followed by radiation and concurrent temozolomide plus rotational multiagent chemotherapy. Cancer. 2009;115(15):3501-3511. CrossRef
Sheleg SV. Lokalnaya khimioterapiya s ispolzovaniyem deponirovannoy formy tsisplatina pri kompleksnom lechenii bolnykh nizkodifferentsirovannymi gliomami golovnogo mozga (eksperimentalno-klinicheskoye issledovaniye) [dissertation]. Minsk (Belarus): NN Alexandrov National Cancer Centre of Belarus; 2002. Russian.
Lukasheyko YuN. Intraoperatsionnaya lokal'naya khimioterapiya supratentorial'nykh glioma golovnogo mozga tsisplatinom (otsenka i prognozirovaniye effektivnosti metoda) [dissertation]. Minsk (Belarus): Republican Research and Clinical Center of Neurology and Neurosurgery; 2006. Russian.
Bychkovskiy PM, Yurkshtovich TL, Kaputskiy FN, Belyayev SA, Adamchik DA, Zhavrid EA, Vakker AV, Shanko YuG, Tanin AL, Korotkevich EA. Tsisplatsel – otechestvennyy protivoopukholevyy preparat dlya lokalnoy khimioterapii zlokachestvennykh novoobrazovaniy golovnogo mozga i opukholey golovy i shei. Onkologicheskiy zhurnal. 2012;6(2):11–12. Russian.
Sinayko VV, Artemova NA. Vliyaniye metodiki luchevoy terapii na otdalennyye rezul'taty lecheniya patsiyentov s vysokozlokachestvennymi (Grade III–IV) gliomami golovnogo mozga. Onkologicheskiy zhurnal. 2014;8(3):24–30. Russian.
Curran WJ Jr, Scott C, Horton JW, Nelson JS, Weinstein AS, Fischbach AJ, Chang CH, Rotman M, Asbell SO, Krisch RE. Recursive Partitioning Analysis of Prognostic Factors in Three Radiation Therapy Oncology Group Malignant Glioma Trials. JNCI Journal of the National Cancer Institute. 1993;85(9):704-710. CrossRef
Korotkevich YeA, Shanko YuG, Grigoriyev DG, Tanin AP, Bulgak VV, Bychkovskiy PM. Lokalnaya khimioterapiya neyroepitelial'nykh opukholey golovnogo mozga. Nevrologiya i neyrokhirurgiya v Belarusi. 2009;3:58–65. Russian.
Harutyunyan L. Results on complex treatment of patients with glial tumors of brain with local chemotherapy. Biopolym Cell. 2011;27(5):373-376. CrossRef
Kleinberg L. Polifeprosan 20, 3.85% carmustine slow-release wafer in malignant glioma: evidence for role in era of standard adjuvant temozolomide. Core Evid. 2012;7:115–130. CrossRef
How to Cite
Copyright (c) 2015 Valeriy Sinajkо, Yuriy Shanko, Evgeniy Korotkevich, Pavel Bychkovsky, Tatyana Yurkshtovich, Yuriy Grachev, Nataliya Artemova
This work is licensed under a Creative Commons Attribution 4.0 International License.
Ukrainian Neurosurgical Journal abides by the CREATIVE COMMONS copyright rights and permissions for open access journals.
Authors, who are published in this Journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the Journal under the terms of Creative Commons Attribution License, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this Journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form of which it has been published by the Journal (for example, to upload the work to the online storage of the Journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this Journal is included.