Hyperthermia in combination with ACNU chemotherapy in the treatment of recurrent glioblastoma

Purpose: The glioblastoma represents a brain tumor with a extremely bad prognosis. Especially in the case of recurrent disease new therapeutic strategies are necessary to overcome the resistance of the tumor cells against cytostatic substances. The effect of a combination of ACNU chemotherapy and local radiofrequency hyperthermia should be tested in patients suffered on recurrent glioblastoma.

Patients and methods: 19 patients with recurrent glioblastoma, after primary therapy with surgery and radiation therapy, were treated in our hospital once a week with ACNU (60 mg/m2) and local electro- hyperthermia (13,56 MHz) with a duration of 60 min. The mean temperature reached in tumor tissue was 41.60C. Treatment was given for three weeks, interrupted for three weeks and repeated until progression.

Results: Two patients (11%) showed a partial remission according to the standard criteria; 6 patients (31%) had a stable disease. 11(58%) did not respond to the therapy and showed progressive disease. The median survival time was 8.5 months, median time to progression was 7.5 months. The observed hematologic toxicity was low, only 2 patients (11%) developed a leucopenia grade 2 or 3. Thrombopenia of grade 2 and more occurred in 5 patients (26%).

Conclusion. The combined treatment is active in the therapy of recurrent glioblastoma and well tolerated. Further prospective and randomized studies are required to show significant clinical profit.