Stereotactic reirradiation with temozolomide in patients with recurrent aggressive pituitary tumors and pituitary carcinomas
Objectives To evaluate the efficacy of a second course of fractionated stereotactic radiotherapy (re-SRT) and temozolomide (TMZ) as salvage treatment option in patients with aggressive pituitary tumors (APTs) and pituitary carcinomas (PCs). Patients and Methods Twenty-one patients with recurrent or...
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| Veröffentlicht in: | Journal of neuro-oncology 2020-08, Vol.149 (1), p.123-130 |
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| container_title | Journal of neuro-oncology |
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| creator | Minniti, Giuseppe Paolini, Sergio Rea, Marie Lise Jaffrain Isidori, Andrea Scaringi, Claudia Russo, Ivana Osti, Mattia Falchetto Cavallo, Luigi Esposito, Vincenzo |
| description | Objectives
To evaluate the efficacy of a second course of fractionated stereotactic radiotherapy (re-SRT) and temozolomide (TMZ) as salvage treatment option in patients with aggressive pituitary tumors (APTs) and pituitary carcinomas (PCs).
Patients and Methods
Twenty-one patients with recurrent or progressive APTs (n = 17) and PCs (n = 4) who received combined TMZ and re-SRT, 36 Gy/18fractions or 37.5 Gy/15fractions, were retrospectively evaluated. TMZ was given at a dose of 75 mg/m
2
given concurrently to re-SRT, and then 150–200 mg/m
2
/day for 5 days every 4 weeks or 50 mg/m
2
daily for 12 months. Local control (LC) and overall survival (OS) were calculated from the time of re-SRT by Kaplan–Meier method.
Results
With a median follow-up of 27 months (range 12–58 months), 2-year and 4-year LC rates were 73% and 65%, respectively; 2-year and 4-year survival rates were 82% and 66%, respectively. A complete response was achieved in 2 and partial response in 11 patients. Six patients recurred with a median time to progression of 14 months.
O
(6)-Methylguanine-DNA methyltransferase (MGMT) status and tumor volume emerged as prognostic factors. Grade 3 radiation-related toxicities occurred in 3 (14%) patients. Grade 2 or 3 hematologic toxicities during chemotherapy occurred in 8 (38%) patients.
Conclusion
Re-SRT and TMZ is a safe treatment offering high LC in patients with progressive APTs and PCs. The potential advantages of combined chemoradiation as up-front or salvage treatment need to be explored in prospective trials. |
| doi_str_mv | 10.1007/s11060-020-03579-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2421108644</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2421108644</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-b57c4a5c886dee62c3aefe563281d15348df0e6c64c385a126e9f185c307e18a3</originalsourceid><addsrcrecordid>eNp9kU1vFSEUhonR2NvqH3BhSNy4GQucAWaWpqkfSRMX1cQdocyZK82d4XpgajT--HKd-pEuXBAC73Pew-Fl7JkUr6QQ9jRLKYxohKoLtO0b_YBtpLbQWLDwkG2ENLbRffv5iB3nfC2EaC3Ix-wIlAHV9XrDfl4WJEzFhxIDJ4xEfoi-xDTzb7F84QWn9CPt0hQH5HHm-6rhXPKqEoaFqJ65324Jc443yPexLLF4-s7LMiXK3M_DP5fBU4hzmnx-wh6Nfpfx6d1-wj69Of949q65-PD2_dnriyaA1aW50ja0XoeuMwOiUQE8jqgPI8hBami7YRRogmkDdNpLZbAfZacDCIuy83DCXq6-e0pfF8zFTTEH3O38jGnJTrWqfmVn2raiL-6h12mhub6uUmAN9KB0pdRKBUo5E45uT3Gqwzkp3CEbt2bjajbuVzbuUPT8znq5mnD4U_I7jArACuQqzVukv73_Y3sL3p6dIw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2437639325</pqid></control><display><type>article</type><title>Stereotactic reirradiation with temozolomide in patients with recurrent aggressive pituitary tumors and pituitary carcinomas</title><source>SpringerNature Journals</source><creator>Minniti, Giuseppe ; Paolini, Sergio ; Rea, Marie Lise Jaffrain ; Isidori, Andrea ; Scaringi, Claudia ; Russo, Ivana ; Osti, Mattia Falchetto ; Cavallo, Luigi ; Esposito, Vincenzo</creator><creatorcontrib>Minniti, Giuseppe ; Paolini, Sergio ; Rea, Marie Lise Jaffrain ; Isidori, Andrea ; Scaringi, Claudia ; Russo, Ivana ; Osti, Mattia Falchetto ; Cavallo, Luigi ; Esposito, Vincenzo</creatorcontrib><description>Objectives
To evaluate the efficacy of a second course of fractionated stereotactic radiotherapy (re-SRT) and temozolomide (TMZ) as salvage treatment option in patients with aggressive pituitary tumors (APTs) and pituitary carcinomas (PCs).
Patients and Methods
Twenty-one patients with recurrent or progressive APTs (n = 17) and PCs (n = 4) who received combined TMZ and re-SRT, 36 Gy/18fractions or 37.5 Gy/15fractions, were retrospectively evaluated. TMZ was given at a dose of 75 mg/m
2
given concurrently to re-SRT, and then 150–200 mg/m
2
/day for 5 days every 4 weeks or 50 mg/m
2
daily for 12 months. Local control (LC) and overall survival (OS) were calculated from the time of re-SRT by Kaplan–Meier method.
Results
With a median follow-up of 27 months (range 12–58 months), 2-year and 4-year LC rates were 73% and 65%, respectively; 2-year and 4-year survival rates were 82% and 66%, respectively. A complete response was achieved in 2 and partial response in 11 patients. Six patients recurred with a median time to progression of 14 months.
O
(6)-Methylguanine-DNA methyltransferase (MGMT) status and tumor volume emerged as prognostic factors. Grade 3 radiation-related toxicities occurred in 3 (14%) patients. Grade 2 or 3 hematologic toxicities during chemotherapy occurred in 8 (38%) patients.
Conclusion
Re-SRT and TMZ is a safe treatment offering high LC in patients with progressive APTs and PCs. The potential advantages of combined chemoradiation as up-front or salvage treatment need to be explored in prospective trials.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-020-03579-5</identifier><identifier>PMID: 32632895</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Brain cancer ; Brain tumors ; Carcinoma ; Chemoradiotherapy ; Chemotherapy ; Clinical Study ; Clinical trials ; DNA methyltransferase ; Medical prognosis ; Medicine ; Medicine & Public Health ; Methylguanine ; Neurology ; O6-methylguanine-DNA methyltransferase ; Oncology ; Pituitary ; Pituitary gland ; Radiation therapy ; Survival ; Temozolomide ; Tumors</subject><ispartof>Journal of neuro-oncology, 2020-08, Vol.149 (1), p.123-130</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-b57c4a5c886dee62c3aefe563281d15348df0e6c64c385a126e9f185c307e18a3</citedby><cites>FETCH-LOGICAL-c375t-b57c4a5c886dee62c3aefe563281d15348df0e6c64c385a126e9f185c307e18a3</cites><orcidid>0000-0003-1239-1603</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11060-020-03579-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11060-020-03579-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32632895$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Minniti, Giuseppe</creatorcontrib><creatorcontrib>Paolini, Sergio</creatorcontrib><creatorcontrib>Rea, Marie Lise Jaffrain</creatorcontrib><creatorcontrib>Isidori, Andrea</creatorcontrib><creatorcontrib>Scaringi, Claudia</creatorcontrib><creatorcontrib>Russo, Ivana</creatorcontrib><creatorcontrib>Osti, Mattia Falchetto</creatorcontrib><creatorcontrib>Cavallo, Luigi</creatorcontrib><creatorcontrib>Esposito, Vincenzo</creatorcontrib><title>Stereotactic reirradiation with temozolomide in patients with recurrent aggressive pituitary tumors and pituitary carcinomas</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Objectives
To evaluate the efficacy of a second course of fractionated stereotactic radiotherapy (re-SRT) and temozolomide (TMZ) as salvage treatment option in patients with aggressive pituitary tumors (APTs) and pituitary carcinomas (PCs).
Patients and Methods
Twenty-one patients with recurrent or progressive APTs (n = 17) and PCs (n = 4) who received combined TMZ and re-SRT, 36 Gy/18fractions or 37.5 Gy/15fractions, were retrospectively evaluated. TMZ was given at a dose of 75 mg/m
2
given concurrently to re-SRT, and then 150–200 mg/m
2
/day for 5 days every 4 weeks or 50 mg/m
2
daily for 12 months. Local control (LC) and overall survival (OS) were calculated from the time of re-SRT by Kaplan–Meier method.
Results
With a median follow-up of 27 months (range 12–58 months), 2-year and 4-year LC rates were 73% and 65%, respectively; 2-year and 4-year survival rates were 82% and 66%, respectively. A complete response was achieved in 2 and partial response in 11 patients. Six patients recurred with a median time to progression of 14 months.
O
(6)-Methylguanine-DNA methyltransferase (MGMT) status and tumor volume emerged as prognostic factors. Grade 3 radiation-related toxicities occurred in 3 (14%) patients. Grade 2 or 3 hematologic toxicities during chemotherapy occurred in 8 (38%) patients.
Conclusion
Re-SRT and TMZ is a safe treatment offering high LC in patients with progressive APTs and PCs. The potential advantages of combined chemoradiation as up-front or salvage treatment need to be explored in prospective trials.</description><subject>Brain cancer</subject><subject>Brain tumors</subject><subject>Carcinoma</subject><subject>Chemoradiotherapy</subject><subject>Chemotherapy</subject><subject>Clinical Study</subject><subject>Clinical trials</subject><subject>DNA methyltransferase</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methylguanine</subject><subject>Neurology</subject><subject>O6-methylguanine-DNA methyltransferase</subject><subject>Oncology</subject><subject>Pituitary</subject><subject>Pituitary gland</subject><subject>Radiation therapy</subject><subject>Survival</subject><subject>Temozolomide</subject><subject>Tumors</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1vFSEUhonR2NvqH3BhSNy4GQucAWaWpqkfSRMX1cQdocyZK82d4XpgajT--HKd-pEuXBAC73Pew-Fl7JkUr6QQ9jRLKYxohKoLtO0b_YBtpLbQWLDwkG2ENLbRffv5iB3nfC2EaC3Ix-wIlAHV9XrDfl4WJEzFhxIDJ4xEfoi-xDTzb7F84QWn9CPt0hQH5HHm-6rhXPKqEoaFqJ65324Jc443yPexLLF4-s7LMiXK3M_DP5fBU4hzmnx-wh6Nfpfx6d1-wj69Of949q65-PD2_dnriyaA1aW50ja0XoeuMwOiUQE8jqgPI8hBami7YRRogmkDdNpLZbAfZacDCIuy83DCXq6-e0pfF8zFTTEH3O38jGnJTrWqfmVn2raiL-6h12mhub6uUmAN9KB0pdRKBUo5E45uT3Gqwzkp3CEbt2bjajbuVzbuUPT8znq5mnD4U_I7jArACuQqzVukv73_Y3sL3p6dIw</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Minniti, Giuseppe</creator><creator>Paolini, Sergio</creator><creator>Rea, Marie Lise Jaffrain</creator><creator>Isidori, Andrea</creator><creator>Scaringi, Claudia</creator><creator>Russo, Ivana</creator><creator>Osti, Mattia Falchetto</creator><creator>Cavallo, Luigi</creator><creator>Esposito, Vincenzo</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1239-1603</orcidid></search><sort><creationdate>20200801</creationdate><title>Stereotactic reirradiation with temozolomide in patients with recurrent aggressive pituitary tumors and pituitary carcinomas</title><author>Minniti, Giuseppe ; Paolini, Sergio ; Rea, Marie Lise Jaffrain ; Isidori, Andrea ; Scaringi, Claudia ; Russo, Ivana ; Osti, Mattia Falchetto ; Cavallo, Luigi ; Esposito, Vincenzo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-b57c4a5c886dee62c3aefe563281d15348df0e6c64c385a126e9f185c307e18a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Brain cancer</topic><topic>Brain tumors</topic><topic>Carcinoma</topic><topic>Chemoradiotherapy</topic><topic>Chemotherapy</topic><topic>Clinical Study</topic><topic>Clinical trials</topic><topic>DNA methyltransferase</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methylguanine</topic><topic>Neurology</topic><topic>O6-methylguanine-DNA methyltransferase</topic><topic>Oncology</topic><topic>Pituitary</topic><topic>Pituitary gland</topic><topic>Radiation therapy</topic><topic>Survival</topic><topic>Temozolomide</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Minniti, Giuseppe</creatorcontrib><creatorcontrib>Paolini, Sergio</creatorcontrib><creatorcontrib>Rea, Marie Lise Jaffrain</creatorcontrib><creatorcontrib>Isidori, Andrea</creatorcontrib><creatorcontrib>Scaringi, Claudia</creatorcontrib><creatorcontrib>Russo, Ivana</creatorcontrib><creatorcontrib>Osti, Mattia Falchetto</creatorcontrib><creatorcontrib>Cavallo, Luigi</creatorcontrib><creatorcontrib>Esposito, Vincenzo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuro-oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Minniti, Giuseppe</au><au>Paolini, Sergio</au><au>Rea, Marie Lise Jaffrain</au><au>Isidori, Andrea</au><au>Scaringi, Claudia</au><au>Russo, Ivana</au><au>Osti, Mattia Falchetto</au><au>Cavallo, Luigi</au><au>Esposito, Vincenzo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stereotactic reirradiation with temozolomide in patients with recurrent aggressive pituitary tumors and pituitary carcinomas</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>149</volume><issue>1</issue><spage>123</spage><epage>130</epage><pages>123-130</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Objectives
To evaluate the efficacy of a second course of fractionated stereotactic radiotherapy (re-SRT) and temozolomide (TMZ) as salvage treatment option in patients with aggressive pituitary tumors (APTs) and pituitary carcinomas (PCs).
Patients and Methods
Twenty-one patients with recurrent or progressive APTs (n = 17) and PCs (n = 4) who received combined TMZ and re-SRT, 36 Gy/18fractions or 37.5 Gy/15fractions, were retrospectively evaluated. TMZ was given at a dose of 75 mg/m
2
given concurrently to re-SRT, and then 150–200 mg/m
2
/day for 5 days every 4 weeks or 50 mg/m
2
daily for 12 months. Local control (LC) and overall survival (OS) were calculated from the time of re-SRT by Kaplan–Meier method.
Results
With a median follow-up of 27 months (range 12–58 months), 2-year and 4-year LC rates were 73% and 65%, respectively; 2-year and 4-year survival rates were 82% and 66%, respectively. A complete response was achieved in 2 and partial response in 11 patients. Six patients recurred with a median time to progression of 14 months.
O
(6)-Methylguanine-DNA methyltransferase (MGMT) status and tumor volume emerged as prognostic factors. Grade 3 radiation-related toxicities occurred in 3 (14%) patients. Grade 2 or 3 hematologic toxicities during chemotherapy occurred in 8 (38%) patients.
Conclusion
Re-SRT and TMZ is a safe treatment offering high LC in patients with progressive APTs and PCs. The potential advantages of combined chemoradiation as up-front or salvage treatment need to be explored in prospective trials.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32632895</pmid><doi>10.1007/s11060-020-03579-5</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1239-1603</orcidid></addata></record> |
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| ispartof | Journal of neuro-oncology, 2020-08, Vol.149 (1), p.123-130 |
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| subjects | Brain cancer Brain tumors Carcinoma Chemoradiotherapy Chemotherapy Clinical Study Clinical trials DNA methyltransferase Medical prognosis Medicine Medicine & Public Health Methylguanine Neurology O6-methylguanine-DNA methyltransferase Oncology Pituitary Pituitary gland Radiation therapy Survival Temozolomide Tumors |
| title | Stereotactic reirradiation with temozolomide in patients with recurrent aggressive pituitary tumors and pituitary carcinomas |
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