| Interferon-alpha2a and 13-cis-retinoic acid with radiation treatment for high-grade glioma. | |
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MedLine Citation:
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PMID: 11305415 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Interferon-alpha (IFN-alpha) has been safely given concurrently with radiation therapy (RT) in treating gliomas. As single agents, both IFN-alpha and cis-retinoic acid (CRA) have produced objective tumor regressions in patients with recurrent gliomas. In vitro, IFN-alpha2a and CRA enhance radiation therapy effects on glioblastoma cells more than either agent alone. This trial was conducted to determine the clinical effects of IFN-alpha2a and CRA when given concurrently with radiation therapy to patients with high-grade glioma. Newly diagnosed patients with high-grade glioma received IFN-alpha2a at a dosage of 3 to 6 million IU s.c. 4 times a day for 3 days per week and 1 mg/kg CRA by mouth 4 times a day for 5 days per week during the delivery of partial brain radiation therapy at 180 cGy x 33 fractions for 5 days per week for a total of 59.4 Gy during the 7-week period. Use of the antiepileptic phenytoin was prohibited after observing that the combination of IFN-alpha2a, CRA, and phenytoin was associated with a high rate of dermatologic toxicity not seen in a previous study with concurrent IFN-alpha2a and radiation therapy. Forty patients (26 men and 14 women) with a median age of 60 (range, 19 to 81 years) were enrolled between August 1996 and October 1998. Histopathologic diagnoses were glioblastoma multiforme or grade 4 anaplastic astrocytoma in 36 patients, and grade 3 anaplastic astrocytoma in 4 patients. Only 4 patients (10%) underwent a gross total resection of tumor prior to this therapy; 50% were asymptomatic when treatment was initiated. The planned 7-week course of concurrent therapy was completed by 75% of patients; 30% completed the 16-week course of IFN-alpha and CRA alone. At a median follow-up of 36 months, there were 37 deaths, with a median overall survival of 9.3 months and a 1-year survival rate of 42%. There was no improvement in survival compared with a similar group of 19 patients treated with concurrent IFN-alpha2a and radiation therapy in a previous trial. In the high-risk group of patients in the present study, concurrent treatment with IFN-alpha2a, CRA, and RT was feasible, but was not associated with a better outcome compared with a similar patient population treated with radiation therapy and IFN-alpha2a, or compared with radiation therapy alone in other trials. |
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Authors:
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R O Dillman; W M Shea; D F Tai; K Mahdavi; N M Barth; B R Kharkar; M M Poor; C K Church; C DePriest |
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Publication Detail:
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Type: Clinical Trial; Clinical Trial, Phase II; Journal Article |
Journal Detail:
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Title: Neuro-oncology Volume: 3 ISSN: 1522-8517 ISO Abbreviation: Neuro-oncology Publication Date: 2001 Jan |
Date Detail:
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Created Date: 2001-04-17 Completed Date: 2001-05-31 Revised Date: 2008-11-20 |
Medline Journal Info:
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Nlm Unique ID: 100887420 Medline TA: Neuro Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 35-41 Citation Subset: IM |
Affiliation:
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Hoag Cancer Center, Newport Beach, CA 92658, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Antineoplastic Agents / therapeutic use* Brain Neoplasms / drug therapy*, mortality, radiotherapy, surgery Chemotherapy, Adjuvant Combined Modality Therapy Craniotomy Drug Eruptions / etiology Female Glioblastoma / drug therapy*, mortality, radiotherapy, surgery Humans Hypertriglyceridemia / chemically induced Immunologic Factors / therapeutic use* Interferon Alfa-2a / therapeutic use* Isotretinoin / adverse effects, therapeutic use* Life Tables Male Middle Aged Phenytoin / adverse effects, contraindications Radiation Injuries / etiology Radioisotope Teletherapy* / adverse effects Survival Analysis Treatment Failure |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 0/Immunologic Factors; 4759-48-2/Isotretinoin; 57-41-0/Phenytoin; 76543-88-9/Interferon Alfa-2a |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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