HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Friedman, H. S. Articles by Oakes, W. J. Search for Related Content PubMed PubMed Citation Articles by Friedman, H. S. Articles by Oakes, W. J.

Criteria for termination of phase II chemotherapy for patients with progressive or recurrent brain tumor

Department of Pediatrics, Duke University Medical Center, Durham, NC. (Drs. Friedman, Kurtzberg, Longee, Halperin, Falletta, and Oakes)
Department of Radiology, Duke University Medical Center, Durham, NC. (Drs. Djang, Halperin, and Coleman)
Department of Medicine, Duke University Medical Center, Durham, NC. (Dr. Schold)
Department of Surgery, Duke University Medical Center, Durham, NC. (Dr. Oakes)

We report six patients with progressive primary tumors of the brain who had prolonged periods with stable contrast-enhancing CT lesions following initial responses to chemotherapy. Chemotherapy was discontinued after 21 to 36 months, despite the persistence of apparent disease in each patient. PET using (F-18) fluorodeoxyglucose was performed in three patients, revealing hypometabolic lesions. All six patients are alive and well, with no clinical or radiographic evidence of progressive disease at 24 to 57+ months following termination of treatment. The usual criteria for terminating phase II chemotherapy in patients with a recurrent brain tumor are evidence of progressive disease or unacceptable toxicity. However, chemotherapeutic success mandates that these criteria be expanded to include patients whose response following the initiation of phase II treatment is followed by prolonged (greater than 1 year) radiographic and clinical stability. Complete response, ie, disappearance of all evidence of disease, is unusual in patients with recurrent primary brain tumors, even with highly effective therapy. Continued improvement in the therapy of patients with these tumors will allow wider application of these criteria.

Address correspondence and reprint requests to Dr. Friedman, PO Box 2916, Department of Pediatrics, Division of Oncology, Duke Medical Center, Durham, NC 27710.

Supported by American Cancer Society Grant CH 403 and NIH Grants NS 20023, CA 44640, 1 K07 NS 00958, and CA 15525. Dr. Halperin is a recipient of an American Cancer Society Clinical Oncology Cancer Development Award. Dr. Schold is a recipient of a Jacob Javits Investigator Award from the NINCDS.

Received May 12, 1988. Accepted for publication in final form July 7, 1988.

This article has been cited by other articles:

				R. J. Downey, T. Akhurst, D. Ilson, R. Ginsberg, M. S. Bains, M. Gonen, H. Koong, M. Gollub, B. D. Minsky, M. Zakowski, et al. Whole Body 18FDG-PET and the Response of Esophageal Cancer to Induction Therapy: Results of a Prospective Trial J. Clin. Oncol., February 1, 2003; 21(3): 428 - 432. [Abstract] [Full Text] [PDF]

				S. Cha, E. A. Knopp, G. Johnson, A. Litt, J. Glass, M. L. Gruber, S. Lu, and D. Zagzag Dynamic Contrast-enhanced T2*-weighted MR Imaging of Recurrent Malignant Gliomas Treated with Thalidomide and Carboplatin AJNR Am. J. Neuroradiol., May 1, 2000; 21(5): 881 - 890. [Abstract] [Full Text]