This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (31)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Oncology  • Brain Cancer  • Alert me on articles by topic

Marc C. Chamberlain, MD; Patty A. Kormanik, RN, CNP

Arch Neurol. 1999;56:703-708.

Background  A prospective phase 2 study of daily oral tamoxifen citrate in young adults with recurrent anaplastic astrocytomas.

Methods  Twenty-four patients (15 men; 9 women) aged 19 to 45 years (median age, 31.5 years) with recurrent anaplastic astrocytomas were treated. All patients had been treated previously with surgery and involved-field radiotherapy (median dose, 60 Gy; range, 59-61 Gy). In addition, 22 patients were treated adjuvantly with nitrosourea-based chemotherapy (combined procarbazine hydrochloride, lomustine, and vincristine sulfate in 16; carmustine in 6). All patients were treated with salvage chemotherapy at first recurrence, with 1 to 4 chemotherapy regimens (median, 1 regimen). Tamoxifen citrate was administered orally at a fixed dosage of 80 mg/m² as a single or a twice-daily dosage. Neurologic and neuroradiographic evaluation were performed every 12 weeks, operationally defined as a single cycle of tamoxifen.

Results  All patients were able to undergo evaluation. A median of 4 cycles of tamoxifen (range, 1-8 cycles) were administered. No tamoxifen-related toxic effects were seen, nor were there any treatment-related deaths. Four patients (17%) demonstrated a neuroradiographic partial response; 11 patients (46%), stable disease; and 9 patients (38%), progressive disease following a single cycle of tamoxifen. Time to tumor progression ranged from 3 to 25 months (median, 12 months). Survival ranged from 3 to 27 months (median, 13 months). Five patients are alive, with 3 receiving alternative chemotherapy regimens and 2 continuing to receive tamoxifen. In the group with responding and stable disease, median survival was 15 months (range, 8-27 months).

Conclusion  Tamoxifen demonstrated modest efficacy with no apparent toxic effects in this heavily pretreated cohort of young adults with recurrent anaplastic astrocytomas.

From the Department of Neurology, Kaiser Permanente Medical Group, Baldwin Park, Calif (Dr Chamberlain); and the Department of Nursing, University of California, San Diego (Ms Kormanik).

RELATED ARTICLE

Archives of Neurology Reader's Choice: Continuing Medical Education
Arch Neurol. 1999;56(6):762-764.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Randomized study of Paclitaxel and tamoxifen deposition into human brain tumors: implications for the treatment of metastatic brain tumors.
Fine et al.
Clin. Cancer Res. 2006;12:5770-5776.
ABSTRACT | FULL TEXT  

Targeting Protein Kinase C: New Therapeutic Opportunities Against High-Grade Malignant Gliomas?
da Rocha et al.
The Oncologist 2002;7:17-33.
ABSTRACT | FULL TEXT  

Tamoxifen Effects on Endothelial Function and Cardiovascular Risk Factors in Men With Advanced Atherosclerosis
Clarke et al.
Circulation 2001;103:1497-1502.
ABSTRACT | FULL TEXT  

Radiation Therapy and High-Dose Tamoxifen in the Treatment of Patients With Diffuse Brainstem Gliomas: Results of a Brazilian Cooperative Study
Broniscer et al.
JCO 2000;18:1246-1253.
ABSTRACT | FULL TEXT