CONCURRENT RADIATION AND INTRACAROTID CISPLATIN INFUSION IN MALIGNANTGLIOMAS - A FEASIBILITY STUDY

Twenty-two patients with supratentorial malignant gliomas were treated postoperatively with concurrent intracarotid chemotherapy and radiati on therapy. There were seven women and 15 men with a median age of 56 years (range, 22-69) and median performance status (Karnofsky score) o f 70 (range, 40-90). In all except two cases, histologic studies confi rmed malignant glioma, All patients were irradiated with a cobalt 60 e quipment. They should have received 45 Gy to the whole brain plus a 15 -Gy coned-down boost to the tumor area. Chemotherapy consisted of cisp latin infusion at a dose of 60 mg/m(2) on days 2, 22, and 42. Treatmen t was interrupted in two patients because of progressive disease and v oluntary withdrawal in one patient each, In all, 63 courses of cisplat in infusion were administered, all at full dose, Two patients achieved a partial response, and nine had stable disease, Toxicities included nausea/vomiting in nine patients (41%) and transient hemiparesis, conf usion, diarrhea, and thrombophlebitis in one patient each, Median time to progression was 26 weeks (range, 4-226+), and median survival was 58 weeks(range, 14-226+), In conclusion, the present study suggests th at intracarotid cisplatin administered concurrently with radiation doe s not improve the therapeutic index in malignant gliomas.