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Journal of Neuro-Oncology

, Volume 72, Issue 2, pp 125–131 | Cite as

Intratumoral delivery of mitoxantrone in association with 90-Y radioimmunotherapy (RIT) in recurrent glioblastoma

  • Amerigo Boiardi
  • Mirco Bartolomei
  • Antonio Silvani
  • Marica Eoli
  • Andrea Salmaggi
  • Elena Lamperti
  • Ida Milanesi
  • Andrea Botturi
  • Paola Rocca
  • Lisa Bodei
  • Giovanni Broggi
  • Giovanni Paganelli
Clinical Study

Summary

Twenty-six recurrent Glioblastoma (rGBM) patients sequentially treated at the National Neurological Institute ‘C Besta’ were enrolled for a second surgery in order to remove recurrent tumor and to place an Ommaya reservoire to allow local delivery of chemotherapy and local pre-targeted radio-immunotherapy (RIT). All patients had partial tumor resection and 75% of them had a residual tumor mass after exeresis larger than 2 cm. After surgery all patients were managed with a second line systemic chemotherapy (PCV). Moreover the protocol scheduled two cycles of local RIT (90 Yttrium 5– 25 mCi per cycle) with a 10 week interval. Locoregional mitoxantrone chemotherapy was locally delivered as a single dose of 4 mg every 20 days. Responses to treatment were assessed by monthly neurological examination and by MRI or contrast-enhanced CT scan performed every 2 months.

For the whole group of patients the PFS after second surgery at 6 and 12 months was 61% and 22%, respectively and survival after recurrence at 6, 12 and 18 months was 80%, 53% and 42%, respectively. Neither major side effects occurred systemically nor related on the place of local injections. The percentage of long-term survivors was very high: 42% of patients were still alive at 18 months. We stress the concept that the combined treatments could be more effective if delivered into a smaller residual tumor mass and probably in an adjuvant setting, before tumour recurrence.

Keywords

locoregional chemotherapy locoregional radioimmunotherapy mitoxantrone recurrent glioblastoma 

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Copyright information

© Springer 2005

Authors and Affiliations

  • Amerigo Boiardi
    • 1
  • Mirco Bartolomei
    • 4
  • Antonio Silvani
    • 1
  • Marica Eoli
    • 1
  • Andrea Salmaggi
    • 1
  • Elena Lamperti
    • 1
  • Ida Milanesi
    • 3
  • Andrea Botturi
    • 1
  • Paola Rocca
    • 4
  • Lisa Bodei
    • 4
  • Giovanni Broggi
    • 2
  • Giovanni Paganelli
    • 4
  1. 1.Department of Neuro-oncologyIstituto Nazionale Neurologico, “C. Besta”MilanItaly
  2. 2.Department of NeurosurgeryIstituto Nazionale Neurologico, “C. Besta”MilanItaly
  3. 3.Radiotherapy UnitIstituto Nazionale Neurologico, “C. Besta”MilanItaly
  4. 4.Nuclear Medicine UnitIstituto Oncologico EuropeoMilanItaly

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