Preview

Siberian journal of oncology

Advanced search

ADJUVANT CHEMORADIOTHERAPY WITH LOCAL HYPERTHERMIA IN COMBINED TREATMENT OF PRIMARY GLIOBLASTOMA: PRELIMINARY RESULTS

https://doi.org/10.21294/1814-4861-2017-16-1-32-38

Abstract

A new technique of concurrent chemoradiotherapy and local electromagnetic hyperthermia for treatment of patients with newly diagnosed glioblastoma was developed at the Cancer Research Institute of Tomsk National Research Medical Center. A total of 20 patients with glioblastoma received concurrent chemoradiotherapy with temozolamide and local hyperthermia. Local hyperthermia was performed using the Celsius TCS device, 2 times a week (8–10 sessions). All patients tolerated the treatment well. The most common toxicity profile of concurrent thermochemoradiotherapy with temozolamide was hematological and neurological. It should be noted that no neurological toxicity was found in randomized trials of chemoradiotherapy with temodal. If the predominant hematologic toxicity might be associated with a small sample of patients in the study, the neurologic toxicity was likely to be related with greater toxic effects of chemotherapy on the brain during local hyperthermia, however, the causes of neurological toxicity during adjuvant chemotherapy courses at the moment we can not explain. Short-term results of concurrent thermochemoradiotherapy demonstrated the objective response rate of 70 %, however, adjuvant chemotherapy produced an increase in the incidence of disease progression during adjuvant chemotherapy. One-year recurrence-free survival rate was 53.3 ± 13.3 %, with a median time to progression of 10.5 months. One-year overall survival rate was 91.7 ± 8 % at a median follow-up time of 9 months. The median overall survival was not reached. A short follow-up time did not allow us to make conclusions about the impact of local hyperthermia on the treatment outcomes. However, there was a tendency towards increase in recurrence-free and overall survivals in patients with newly diagnosed glioblastoma.

About the Authors

A. I. Ryabova
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, Junior Researcher, Head and Neck Cancer Department, Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences

SPIN-code: 3128-2940.



V. A. Novikov
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, DSc, Leading Researcher, Head and Neck Cancer Department, Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences

SPIN-code: 9350-3617.



O. V. Gribova
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, PhD, Researcher, Radiology Department, Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences

SPIN-code: 1405-1669.



E. L. Choynzonov
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk Siberian State Medical University, Tomsk
Russian Federation

MD, DSc, Professor, Member of Russian Academy of Sciences, Director of the Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences; Head of the Department of Oncology, Siberian State Medical University

SPIN-code: 2240-8730. 



Zh. A. Startseva
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, DSc, Head of the Radiology Department, Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences

SPIN-code: 8121-0310.



E. E. Bober
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, PhD, Researcher, Department of Diagnostic Imaging, Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences

SPIN-code: 1600-6450.



References

1. Preusser M., de Ribaupierre S., Wöhrer A., Erridge S.C., Hegi M., Weller M., Stupp R. Current concepts and management of glioblastoma. Ann Neurol. 2011 Jul; 70 (1): 9–21. doi: 10.1002/ana.22425.

2. Chinot O.L., Wick W., Mason W., Henriksson R., Saran F., Nishikawa R., Carpentier A.F., Hoang-Xuan K., Kavan P., Cernea D., Brandes A.A., Hilton M., Abrey L., Cloughesy T. Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma. N Engl J Med. 2014 Feb 20; 370 (8): 709–22. doi: 10.1056/NEJMoa1308345.

3. Kobyakov G.L., Smolin A.V., Bekyashev A.Kh., Absalyamova O.V., Kobyakova E.A., Poddubsky A.A., Inozemtseva M.V. Treatment for recurrent glioblastoma: are there successes? Tumors of head and neck. 2014; 3: 12–20 [in Russian]

4. Stupp R., Hegi M.E., Mason W.P., van den Bent M.J., Taphoorn M.J., Janzer R.C., Ludwin S.K., Allgeier A., Fisher B., Belanger K., Hau P., Brandes A.A., Gijtenbeek J., Marosi C., Vecht C.J., Mokhtari K., Wesseling P., Villa S., Eisenhauer E., Gorlia T., Weller M., Lacombe D., Cairncross J.G., Mirimanoff R.O.; European Organisation for Research and Treatment of Cancer Brain Tumour and Radiation Oncology Groups; National Cancer Institute of Canada Clinical Trials Group. 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. Lancet Oncol. 2009 May; 10 (5): 459–66. doi: 10.1016/S1470-2045(09)70025-7.

5. Yu Z., Zhao G., Zhang Z., Li Y., Chen Y., Wang N., Zhao Z., Xie G. Efficacy and safety of bevacizumab for the treatment of glioblastoma. Exp Ther Med. 2016 Feb; 11 (2): 371–380.

6. Lai A., Tran A., Nghiemphu P.L., Pope W.B., Solis O.E., Selch M., Filka E., Yong W.H., Mischel P.S., Liau L.M., Phuphanich S., Black K., Peak S., Green R.M., Spier C.E., Kolevska T., Polikoff J., Fehrenbacher L., Elashoff R., Cloughesy T. Phase II study of bevacizumab plus temozolomide during and after radiation therapy for patients with newly diagnosed glioblastoma multiforme. J Clin Oncol. 2011 Jan 10; 29 (2): 142–8. doi: 10.1200/JCO.2010.30.2729.

7. Ruiz-Sánchez D., Calero M.A., Sastre-Heres A.J., García M.T., Hernandez M.A., Martinez F.M., Peña-Díaz J. Effectiveness of the bevacizumab-irinotecan regimen in the treatment of recurrent glioblastoma multiforme: Comparison with other secondline treatments without this regimen. Oncol Lett. 2012 Nov; 4 (5): 1114–1118.

8. Gilbert M.R., Dignam J.J., Armstrong T.S., Wefel J.S., Blumenthal D.T., Vogelbaum M.A., Colman H., Chakravarti A., Pugh S., Won M., Jeraj R., Brown P.D., Jaeckle K.A., Schiff D., Stieber V.W., Brachman D.G., WernerWasik M., Tremont-Lukats I.W., Sulman E.P., Aldape K.D., Curran W.J. Jr., Mehta M.P. A randomized trial of bevacizumab for newly diagnosed glioblastoma. N Engl J Med. 2014 Feb 20; 370 (8): 699–708. doi: 10.1056/ NEJMoa1308573.

9. Choinzonov E.L., Gribova O.V., Startseva Zh.A., Ryabova A.I., Novikov V.A., Musabayeva L.I., Polezhayeva I.S. Current approaches to chemoradiotherapy for malignant gliomas. Bulletin of the Siberian medicine. 2014; 13 (3): 119–125 [in Russian]

10. Choynzonov E.L., Startseva Zh.A., Mukhamedov M.R., Spivakova I.O., Cheremisina O.V., Gribova O.V., Kulbakin D.E., Surkova P.V. Local hyperthermia in combined modality treatment of laryngeal and laryngopharyngeal cancer. Siberian Journal of Oncology. 2014; 5: 5–9. [in Russian]

11. Maier-Hauff K., Ulrich F., Nestler D., Niehoff H., Wust P., Thiesen B., Orawa H., Budach V., Jordan A. Efficacy and safety of intratumoral thermotherapy using magnetic iron-oxide nanoparticles combined with external beam radiotherapy on patients with recurrent glioblastoma multiforme. J Neurooncol. 2011 Jun; 103 (2): 317–24. doi: 10.1007/ s11060-010-0389-0.

12. Sun J., Guo M., Pang H., Qi J., Zhang J., Ge Y. Treatment of malignant glioma using hyperthermia. Neural Regen Res. 2013 Oct 15; 8 (29): 2775–82. doi: 10.3969/j.issn.1673-5374.2013.29.009.

13. Szasz A., Iluri N., Szasz O. Local Hyperthermia in Oncology – To Choose or not to Choose? Hyperthermia. Winchester. InTech. 2013; 1–82. doi: 10.5772/52208.

14. Wen P.Y., Norden A.D., Drappatz J., Quant E. Response assessment challenges in clinical trials of gliomas. Curr Oncol Rep. 2010 Jan; 12 (1): 68–75. doi: 10.1007/s11912-009-0078-3.

15. Stupp R., Mason W.P., van den Bent M.J., Weller M., Fisher B., Taphoorn M.J., Belanger K., Brandes A.A., Marosi C., Bogdahn U., Curschmann J., Janzer R.C., Ludwin S.K., GorliaT., Allgeier A., Lacombe D., Cairncross J.G., Eisenhauer E., Mirimanoff R.O.; European Organization for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005 Mar 10; 352 (10): 987–96.


Review

For citations:


Ryabova A.I., Novikov V.A., Gribova O.V., Choynzonov E.L., Startseva Zh.A., Bober E.E. ADJUVANT CHEMORADIOTHERAPY WITH LOCAL HYPERTHERMIA IN COMBINED TREATMENT OF PRIMARY GLIOBLASTOMA: PRELIMINARY RESULTS. Siberian journal of oncology. 2017;16(1):32-38. (In Russ.) https://doi.org/10.21294/1814-4861-2017-16-1-32-38

Views: 1395


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)