Locally delivered chemotherapy and repeated surgery can improve survival in glioblastoma patients

We treated 54 patients, newly diagnosed for glioblastoma, with systemic che motherapy (carmustine (BCNU) 100 mg/m(2) and cisplatin 90 mg/m(2) every 6 w eeks) and radiotherapy soon after surgery. In 10 cases the treatment was co mbined with locoregional chemotherapy (1 mg bleomycin on days 1-2, and 3 mg mitoxantrone on day 3, repeated every 20 days) administered from an Ommaya reservoir. At tumor recurrence, all patients were treated with procarbazin e, lomustine and vincristine (PCV); 15 of 54 were reoperated and treated wi th locoregional chemotherapy. The median time to disease progression (TTP) and overall survival time (ST) for the whole group were 10.8 and 23.1 month s, respectively. The ST of the 15 reoperated patients who also received loc oregional treatment at disease recurrence was 27.6 months; this was signifi cantly longer than that of patients not reoperated and not treated locally (log-rank p=0.04). The results in our reoperated subgroup support the opini on that a second operation could be suitable if it is part of the whole pro gram of treatment.