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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
Rivista di Medicina Nucleare e Imaging Molecolare
A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413
The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2004 September;48(3):220-8
Combined treatment of glioblastoma patients with locoregional pre-targeted 90Y-biotin radioimmunotherapy and temozolomide
Bartolomei M. 1, Mazzetta C. 2, Handkiewicz-Junak D. 1, Bodei L. 1, Rocca P. 1, Grana C. 1, Maira G. 3, Sturiale C. 4, Villa G. 5, Paganelli G. 1
1 Division of Nuclear Medicine IEO, Milan, Italy
2 Division of Epidemiology and Biostatistics IEO, Milan, Italy
3 Department of Neurosurgery Policlinico “A. Gemelli”, Rome, Italy
4 Department of Neurosurgery Ospedale “Bellaria”, Bologna, Italy
5 Division of Radiology IEO, Milan, Italy
Aim. In a previous phase I-II study, the safety profile and anti-tumor efficacy of pre-targeting locoregional radioimmunotherapy (LR-RIT), based on the “3 step” method, was assessed in 24 high-grade glioma patients. The encouraging results in terms of low toxicity and objective response rate (25%) prompted us to continue our study.
Methods. An analysis of 73 patients with hystologically confirmed glioblastoma multiforme (GBM), treated with the “3 step” 90Y-biotin based LR-RIT, is herein reported. All patients had a catheter implanted at 2nd surgery and underwent at least 2 cycles of LR-RIT (range 2-7) with 2 months interval. Thirty-five out of 73 patients were also treated with Temozolomide (TMZ). Two cycles of TMZ (200 mg/m2/day, for 5/28 days) were administered in between each course of LR-RIT. Overall survival (OS) and progression free survival (PFS) were retrospectively calculated.
Results. Stabilization of disease was achieved in 75% of patients, while 25% progressed.
In the 38 patients treated with LR-RIT alone, median OS and PFS were respectively 17.5 months (95%CI=[17-20]) and 5 months (95%CI=[4-8]), while in the 35 treated with the combined treatment (LR-RIT+TMZ) respective values were 25 months (95%CI=[23-30]) and 10 months (95%CI=[9-18] (p<0.01). The addition of TMZ to LR-RIT did not increase neurological toxicity, and no major hematological toxicity was observed.
Conclusion. These results confirm the safety and the efficacy of 90Y LR-RIT in recurrent GBM patients; the addition of TMZ significantly improved the overall outcomes; a further controlled prospective, randomized study is fully justified.