Abstract
Background: Recurrent high grade glioma patients exhibited poor survival. Chemotherapy such as cisplatin and Etoposide may overcome tumor cell resistance. Multiple trials of phase I and II have revealed the safety and efficacy of Temozolomide (TMZ) combined with interferon, nitrosoureas, and bevacizumab and some other chemotherapeutic agents such as irinotecan, pegylated doxorubicin and cisplatin given in progressive as well as recurrent glioblastoma multiforme (GBM). We aimed to evaluate the impact of cisplatin plus TMZ versus Carboplatin plus Etoposide in treatment of recurrent high-grade glioma on clinical outcome. Thus, we prospectively enrolled 25 patients diagnosed as recurrent high-grade glioma who received cisplatin plus TMZ versus other 15 patients received Carboplatin and Etoposide, to evaluated toxicity and survival in both groups.
Results: Both studied arms shown tolerable toxicity finding with no statistical difference. Progression was observed more in patients who were received Carboplatin + Etoposide protocol than those who were received cisplatin + TMZ; but of no statistical significance (P = 0.44), the median PFS of both arms were 5 ± 0.63, and 7 ± 1.87 months, median OS were 9 ± 1.54, and 11 ± 1.66 months, respectively without any significant difference.
Conclusion: Cisplatin plus TMZ combination had shown accepted toxicity profile and accepted survival outcome in terms of PFS and OS in comparison to Carboplatin plus Etoposide protocol without significance. MGMT, EGFR and PI3K molecular studies could convey a promise survival gains.
Key words: Cisplatin, Temozolomide, Carboplatin, Etoposide, glioma