Combination Therapy with Radiation, Temozolomide, and Bevacizumab after Partial Tumor Removal in Glioblastoma Patients with Low Performance Status

• Published in: Gan to kagaku ryoho Vol. 44; no. 6; p. 495
• Main Authors: Nakao, Junzo, Ishikawa, Eiichi, Matsuda, Masahide, Yamamoto, Tetsuya, Takano, Shingo, Matsumura, Akira
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.06.2017
• Subjects: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab - administration & dosage; Chemoradiotherapy; Dacarbazine - administration & dosage; Dacarbazine - analogs & derivatives; Female; Glioblastoma - therapy; Humans; Male; Treatment Outcome
• ISSN: 0385-0684

It is unclear whether or not bevacizumab(Bev)has a curative ability in newly diagnosed glioblastoma(GBM) patients with low Karnofsky performance status(KPS). Four of 14 patients with newly diagnosed GBM received combination therapy with extended local radiation, temozolomide(TMZ), and Bev after partialremovalor biopsy of the tumor. The average patient age was 77.2 years(range 67-85)and the male-to-female ratio was 1:3. In all cases, magnetic resonance imaging showed that combination therapy decreased tumor volume and peritumoral edema volume. The therapy was successfully administered to 3 patients without decreasing their KPS. However, 1 patient with seeding lesions dropped out of therapy because of deteriorating consciousness and decreasing KPS. Subgroup analysis in a randomized control study(AVAglio)showed that patients with a PS score of 1-2(corresponding to a KPS score of 60-80)tended to have prolonged survival after Bev treatment compared with those with a PS score of 0(corresponding to a KPS score of 90-100). In the present study, radiochemotherapy with Bev decreased lesion and edema volumes in all patients, and led to maintained or improved KPS in 3 patients. These results suggest that the treatment is potentially effective for patients with newly diagnosed GBM and lower KPS.