Localized Combo Treatment Promising Against Stubborn Deadly Brain Cancer

By Rachael Myers Lowe, Cancerpage.com

(January 18, 2008) - Combining localized chemotherapy and radiation implants helped patients with recurrent brain cancer to live significantly longer than is typical with standard therapy.

Ohio researchers report in the February issue of the Journal of Neurosurgery that when they combined radiation seed implants with chemotherapy wafers implanted at the site of recurrent glioblastoma multiforme, half the patients lived at least 69 weeks compared to the survival of 26 weeks that is common with one or the other treatment alone. Nearly a quarter of the patients survived 2 years.

Glioblastoma multiforme is a difficult cancer to treat. After surgical removal, it usually returns. Surgeons try to keep returning cancer from spreading to healthy brain tissue.

The combination therapy involves placing iodine-125 radioactive seeds the size of rice pellets in the hole left by the tumor’s removal. The seeds are left there permanently and give off low-level radiation for about 6 months. In addition, nickel-sized wafers infused with carmustine chemotherapy are placed in a single layer along the walls of the cavity.

The combination of seeds and wafers “appears to provide longer survival” compared with studies of seeds and wafers alone, and “disease progression also seems to be further delayed,” said lead researcher, Ronald Warnick, MD, chairman of the Mayfield Clinic and professor of neurosurgery at the University of Cincinnati.

On the downside, about a fourth of the patients experienced greater brain tissue death than is common with standard mono-therapy.

Warnick cautions that this is not the definitive study on the treatment’s effectiveness because of the design of the clinical trial. All 34 participants received the experimental combo treatment. No patients in the clinical trial got standard treatment with which to compare outcomes.

The next step, Warnick says, is to give the combo therapy to patients with a first diagnosis of glioblastoma multiforme.

MGI Pharma, which manufacture’s the Giadel wafers, helped edit the manuscript published in the Journal of Neurosurgery.

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