Intra-arterial Chemo Beneficial for Recurrent Glioblastoma

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  • Glioma
  • Grading of CNS tumors
  • Astrocytoma
  • Grade I: Pilocytic astrocytoma (Juvenile Pilocytic Astrocytoma)
  • Grade I: Subependymal giant cell astrocytoma
  • Grade II: Low-Grade astrocytoma (pilomyxoid astrocytoma)
  • Grade II: Low-grade astrocytoma (pleomorphic xanthoastrocytoma)
  • Grade II: Low-grade astrocytoma (diffuse astrocytoma)
  • Grade III: Anaplastic astrocytoma
  • Grade IV: Glioblastoma multiforme (GBM)
  • Grade IV: Gliosarcoma
  • Grade IV: Giant cell glioblastoma


Intra-arterial Chemo Beneficial for Recurrent Glioblastoma
Intra-arterial Chemo Beneficial for Recurrent Glioblastoma

ANAHEIM, CALIFORNIA—For patients with recurrent glioblastoma, carboplatin-based intra-arterial chemotherapy is relatively safe and well-tolerated, with quality of life being maintained or improved during treatment. This study was presented at the Oncology Nursing Society (ONS) 39th Annual Congress.

“Glioblastomas are the most aggressive brain tumor, and roughly 60% of all brain tumors are glioblastomas. Median survival is 14 to 16 months, with a nearly 100% recurrence rate,” Patricia Bruns, RN, MSN, APN, CNS, of the Minneapolis Clinic of Neurology, said during a podium session. “Despite treatment with radiation and chemotherapy, it remains a devastating diagnosis and recurrence remains a clinical conundrum.”

Standard of care for glioblastoma includes 3D-conformal radiation over 6 weeks with concurrent temozolomide. This is followed by at least 12 cycles of adjuvant temolozomide for 5 days followed by 23 days without treatment. Patients undergo close follow-up with MRI and have office visits at least every 8 weeks or at shorter intervals, depending on their MRI results.

RELATED: Brain Cancer Resource Center

When tumor recurrence occurs, options are limited, according to Bruns. Although many patients attempt other treatments, a vast majority at Bruns' institution receive intra-arterial chemotherapy. For this treatment, a catheter is threaded via the femoral artery to the base of the skull, and chemotherapy is injected into the brain through vessels that feed the tumor.

To evaluate the survival benefit and toxicity profile of this treatment, Bruns and colleagues conducted a retrospective chart review of patients with recurrent glioblastoma who were treated with intra-arterial carboplatin with either bevacizumab (group A) or intra-arterial carboplatin with intravenous chemotherapy agents (group B) from November 2005 to May 2010.

Forty-four patients (average age, 52.5 years; 29 men) were included in the analysis. Thirty were at their first recurrence, 13 were at their second recurrence, and one was at a third recurrence. In terms of the extent of surgery, 25 had undergone complete resection, 11 had undergone partial resection, and eight had undergone biopsies.

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