Summary
Haemetaporphyrin derivative (HpD) mediated photodynamic therapy (PDT) has been investigated
as an adjuvant treatment for cerebral glioma. This study records the survival of patients
at the Royal Melbourne Hospital with residences in the State of Victoria, utilizing
the Victorian Cancer Registry database for patients treated with adjuvant PDT following
surgical resection of the tumour. For primary (newly diagnosed) tumours, median survival
from initial diagnosis was 76.5 months for anaplastic astrocytoma (AA) and 14.3 months
for glioblastoma multiforme (GBM). Seventy-three percent of patients with AA and 25%
with GBM survived longer than 36 months. For recurrent tumour, median survival from
the time of surgery was 66.6 months for AA and 13.5 months for GBM. Fifty-seven percent
of patients with recurrent AA and 41% of patients with recurrent GBM survived longer
than 36 months. Older age at the time of diagnosis was associated with poorer prognosis.
Laser light doses above the sample median of 230 J/cm2 were associated with better prognosis in the 136 patients studied (primary tumour
patients – (HR = 0.50[0.27,0.95],p = 0.033); recurrent tumour patients (HR = 0.75[0.42,1.31],p = 0.312). There was no mortality directly associated with the therapy, three patients
had increased cerebral oedema thought to be related to photodynamic therapy that was
controlled with conventional therapies.
Keywords
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References
- Cancer statistics.CA Cancer J Clin. 2003; 53: 5-26
- Cancer Statistics. CA Cancer J Clin. 2004; 54: 8-29
- Glioblastoma multiforme: an accumulated experience over 10 years.Acta Neurochir. 1995; 137: 29-33
- Brain tumour cooperative group trial 8001.J Neurosurg. 1989; 71: 1-12
- Current therapy for brain tumours.Arch Neurol. 1999; 56: 429-432
Levin VA. Chemotherapy of primary brain tumors. In: Frank BD, editor. Symposium on Neuro-oncology, vol. 3, Neurologic Clinics, 4th ed. York, Penn: WB Saunders; 1985. p. 855–866
- Chemotherapy for malignant gliomas.J Neurosurg. 1988; 68: 1-17
- Superiority of post-radiotherapy adjuvant chemotherapy with CCNU, procarbazine and vincrsitine (PCV) over BCNU for anaplastic gliomas: NCOG 6G61 final report.J Rad Onc Biol Phys. 1990; 18: 321-324
- Adjuvant therapy with dibromodulcitol and BCNU increases survival of adults with malignant glioma.EORTC Brain Tumour Group Neurol. 1994; 44: 1479-1483
- Photodynamic therapy of brain tumors.Semin Surg Oncol. 1995; : 335-345
- Photodynamic therapy for recurrent supratentorial gliomas.Semin Surg Oncol. 1995; 11: 346-354
- Photodynamic therapy for intracranial neoplasms. Literature review and institutional experience.Mol Chem Neuropathol. 1994; 21: 337-352
- Selective uptake of hematoporphyrin derivative into human cerebral glioma.Neurosurgery. 1990; 26: 248-254
- Photodynamic sensitizers.in: DeVita V.T. Hellman S. Rosenberg S.A. Cancer Principles and Practice of Oncology. 2nd ed. J.P. Lippincot, Philadelphia1985: 2272-2279
- Basic principles of photodynamic therapy.J Porphyr Phthalocyan. 2001; 5: 105-129
- Pathology and genetics of Tumours of the central nervous system.in: Kleihues P. Cavanee W.K. World Health Organization Classification of tumours. IARC Press, Lyon2000: 6-69
- The uptake and retention of hematoporphyrin derivative in an in vivo/in vitro model of cerebral glioma.Neurosurgery. 1985; 17: 883-890
- Quantitation of hematoporphyrin derivative in human gliomas, experimental central nervous system tumours and normal tissues.Neurosurgery. 1983; 12: 446-450
StataCorp 2001. Stata Statistical Software: Release 7.0. College Station, TX: Stata Corporation
- Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma.Int J Radiat Oncol Biol Phys. 1989; 16: 1405-1409
- Long term survivors of glioblastoma: statistical aberration or important unrecognised molecular subtype?.Cancer J. 2003; 9: 214-221
- Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial.J Neurosurg. 1978; 49: 333-343
- Primary brain tumors in adults.Lancet. 2003; 361: 323-331
- Randomized comparison of diaziquone and carmustine in the treatment of adults with anaplastic glioma.J Clin Oncol. 1993; 11: 77-83
- An analysis of radiotherapy data from the CNS Cancer Consortium’s randomized prospective trial comparing AZQ to BCNU in the treatment of patients with primary malignant brain tumour.Am J Clin Oncol. 1993; 16: 277-283
- Benefits of adjuvant chemotherapy in high-grade gliomas.Semin Oncol. 2003; 30: 15-18
- Is the long-term survival of patients with intracranial glioblastoma multiforme overstated?.Cancer. 2003; 98: 1745-1748
- Which glioblastoma multiforme patient will become a long-term survivor? A population based study.Ann Neurol. 1999; 46: 183-188
- Long-term survival after malignant glioma: a clinical and histopathological study on the accuracy of the diagnosis in a population based cancer register.Acta Oncol. 1990; 29: 875-878
- Outcomes and prognostic factors in recurrent glioma patients enrolled onto phase II clinical trials.J Clin Oncol. 1999; 17: 2572-2578
- Meta-analysis of radiation therapy with and without adjuvant chemotherapy for malignant gliomas in adults.Cancer. 1993; 71: 2585-2597
- A phase II study of temozolomide vs. procarbazine in patients’ with glioblastoma multiforme at first relapse.Br J Cancer. 2000; 83: 588-593
- A randomized comparison of intra-arterial versus intravenous BCNU, with or without intravenous 5-fluorouracil, for newly diagnosed patients with malignant glioma.J Neurosurg. 1992; 76: 772-781
- Immunotoxins and central nervous system neoplasia.J Neurosurg. 1992; 76: 1-12
- Inhibition of tumour-specific cytotoxic T-lymphocyte responses by transforming growth beta 1.Cancer Res. 1992; 52: 1386-1392
- The effects of local and systemic interferon beta (Fiblaferon) on supratentorial malignant cerebral glioma – a phase II study.Neurosurg Rev. 1991; 14: 203-213
Kondo S, Yin D, Takeuchi J, et al. Tumour necrosis factor-alpha induces an increase in susceptibility of human glioblastoma U87-MG cells to natural killer cell-mediated lysis 1994; 69: 627–632
Barba D, Saris SC, Holder C, Rosenberg SA, Oldfield EH. Intratumoral LAK cell and interleukin-2 therapy of human gliomas 1989; 70: 175–182
Central Brain Tumor Registry of the United States: Statistical Report: Primary Brain Tumors of the United States, 1992–1997. Chicago, IL: Central Brain Tumor Registry of the United States; 2000
- Randomized comparisons of radiotherapy and nitorosoureas for the treatment of malignant glioma after surgery.New Engl J Med. 1980; 303: 1323-1329
- Phase II comparative evaluation of PCNU and carmustine combined with radiation therapy for high-grade glioma.J Clin Oncol. 1993; 11: 1316-1321
- Randomized trial of radiation therapy (RT) plus dibromodulcitol (DBD) versus RT plus BCNU in high grade astrocytoma.J Neurooncol. 1997; 33: 239-250
- A phase III study of radiation therapy plus carmustine with or without recombinant interferon-a in the treatment of patients with newly diagnosed high-grade glioma.Cancer. 2001; 92: 420-433
- Comparison of mixed anaplastic oligoastrocytoma and high grade astrocytoma in North Central Cancer Treatment Group (NCCTG) clinical trials of high-grade glioma (abstract).Proc Am Soc Clin Oncol. 2002; 21: 77a
- Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials.J Natl Cancer Inst. 1993; 85: 704-710
Glioma Meta-Analysis Trialists (GMT) Group: Chemotherapy in adult high-grade glioma: a systematic review and meta-analysis of individual patient data from 12 randomized trials. Lancet 2002; 359: 1011–1018
- Clinical and experimental results of photodynamic therapy in neurosurgery.SPIE Proc. 1995; 2371: 126-128
- Photodynamic therapy of malignant brain tumour.Can J Neurol Sci. 1990; 17: 193-198
- Malignant glioma: who benefits from adjuvant chemotherapy?.Ann Neurol. 1998; 44: 691-695
- Phase III randomised study of postradiotherapy chemotherapy with alpha-difluoromethylornithine-procarbizine, N-(2-chloroethyl)-N′-cyclohexyl-N-nitrosurea, vincristine (DFMO-PCV) versus PCV for glioblastoma multiforme.Clin Cancer Res. 2000; 6: 3878-3884
- Phase III trial of accelerated hyperfractionation with or without difluoromethylornithine (DFMO) versus standard fractionated radiotherapy with or without DFMO for newly diagnosed patients with glioblastoma multiforme.Int J Radiat Oncol Biol Phys. 2001; 49: 71-77
- Phase I study of topotecan plus cranial radiation for glioblastoma multiforme: results of Radiation Therapy Oncology Group Trial 9507.J Clin Oncol. 2001; 19: 1111-1117
- Concurrent accelerated hyperfractionated radiation therapy and carboplatin/etoposide inpatients with malignant glioma: long term results of a phase II study.J Neurooncol. 2001; 51: 133-141
- A phase II study of pre-radiation chemotherapy followed by external beam radiotherapy for the treatment of patients with newly diagnosed glioblastoma multiforme: an Eastern Cooperative Oncology Group Study (E2393).J Neurooncol. 2000; 47: 145-152
- Phase II, two-arm RTOG trial (94-11, of bischloroethyl-nitrosurea plus accelerated hyperfractionated radiotherapy (64.0 or 70.4 Gy) based on tumor volume (>20 or < or =20 cm(2), respectively) in the treatment of newly diagnosed radiosurgery-ineligible glioblastoma multiforme patients.Int J Radiat Oncol Biol Phys. 2000; 48: 1351-1358
- A phase II trial of high-dose bromodeoxyuridine with accelerated fractionation radiotherapy followed by procarbazine, lomustine and vincristine for glioblastoma multiforme.Int J Radiat Oncol Biol Phys. 1999; 45: 127-135
- Radiation and concomitant weekly administration of paclitaxel in patients with glioblastoma multiforme. A Phase II study.J Neurooncol. 1999; 45: 159-165
- Treatment of newly diagnosed glioblastoma multiforme with carmustine, cisplatin and etoposide followed by radiotherapy. A phase II study.J Neurooncol. 1999; 43: 161-166
- Selective tumour uptake of a boronated porphyrin in an animal model of cerebral glioma.Proc Natl Acad Sci. 1992; 89: 1785-1789
- Photodynamic therapy of brain tumours: evaluation of porphyrin uptake versus clinical outcome.J Clin Neurosci. 2004; 11: 584-596
Article info
Publication history
Accepted:
January 24,
2005
Received:
December 14,
2004
Identification
Copyright
© 2005 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
