SALVAGE CHEMOTHERAPY WITH PACLITAXEL FOR RECURRENT OLIGODENDROGLIOMAS

Purpose: A prospective phase II study of paclitaxel was performed in a dult 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 oligo dendrogliomas were treated. All patients had previously been treated w ith 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, fi ve; range, four to six). Fourteen patients were treated adjuvantly wit h radiotherapy and nitrosourea-based chemotherapy; six were treated at recurrence following initial gross total resection with reoperation ( subtotal resection in oil), radiotherapy, and nitrosourea-based chemot herapy. Paclitaxel was administered intravenously at a dose of 175 mg/ m(2) every 3 to 4 weeks with neurologic and neuroradiographic evaluati on every 8 weeks. Results: A median of three cycles of paclitaxel (ran ge, two to 10) were administered. All patients were assessable. Toxici ty included partial alopecia (12 patients), thrombocytopenia (six), ne utropenia (three), and anemia (one). One patient developed neutropenic fever without bacteriologic documentation and four required transfusi on of blood products (RBCs, n = 2; platelet, n = 2). No treatment-rela ted deaths occurred. Ten patients (50%) demonstrated either a neurorad iographic partial response (n = 3) or stable disease (n = 7), with a m edian response and stable disease duration of 10 months (range, 5 to 1 4). Conclusion: paclitaxel demonstrated modest efficacy with minimal t oxicity in this pretreated cohort of adult patients with recurrent hem ispheric oligodendrogliomas. (C) 1991 by American Society of Clinical Oncology.