Twenty-two patients with
brain tumors were initially treated with surgery,
radiation therapy, and/or
adjuvant chemotherapy. Histologic diagnosis included 11
gliomas, seven
ependymomas, one
dysgerminoma, one
teratocarcinoma, one
pinealoma, and one small cell
tumor. At recurrence, documented on computerized tomographic scan,
cisplatin (60 mg/m2/day iv X 2) was given every 3-4 weeks. Seventeen patients received two or more courses and were considered to be evaluable for response. Response parameters included change in the size of
tumor on computerized tomographic scan and/or in clinical findings. Four patients had complete response, five had partial response, four had stable disease, and four had
disease progression. Toxic effects were manageable. The number of patients with grade 3-4 toxic reactions, by category, were: thrombocytic, ten; leukocytic, four; renal, five; metabolic, four; gastrointestinal, none; and neurologic, seven. Two of the 14 patients tested had grade 3-4
ototoxicity. Acute fluid retention with decreased serum
electrolytes and serious but reversible changes in the mental status, which were experienced in earlier patients, decreased in severity with increasing experience of the investigator. In summary,
cisplatin appears to be active in a spectrum of
brain tumors and should be studied further for therapeutic efficacy.