NDLI: P13CHANGING DOSE BANDINGS TO IMPROVE COMPLIANCE WITH TEMOZOLOMIDE CONCOMITANT WITH RADIOTHERAPY FOR HIGH GRADE GLIOMA; AN ANALYSIS OF SAFETY

Content Provider	PubMed Central
Author	Mathew, T. Clenton, S. Bradshaw, A. G.
Copyright Year	2014
Abstract	INTRODUCTION: The current standard of care for the treatment of grade IV glioma is radiotherapy with concomitant temozolomide chemotherapy which conveys a 2.5 month improvement in overall survival and a 2.5 fold improvement in 2 year survival when compared to radiotherapy alone. The dose of concomitant Temozolomide, 75 mg/m2, often results in a complicated regimen of capsules of differing doses and has led to a clinical incident were the patient mixed up their different strength capsules resulting in an overdose. We changed the dose banding, rounding to the nearest 20 mg rather than 10 mg which was our previous practice, thereby eliminating the use of the 5 mg capsule. Using the previous dose banding the maximum potential dose received would be 78.6 mg/m2 however this increases to a potential 80.8 mg/m2 with the new dose banding. This is still below the maximum tolerated dose of 85 mg/m2 reported in the phase I trial. We audited the non-completion rate pre and post change and performed a root-cause analysis of any omitted doses to ensure tolerance of the new dose banding. METHOD: Retrospective case note analysis of all patients who underwent concomitant chemoradiotherapy for glioma 2 years before the dosage change and this was compared to those treated up to 20 months post change. RESULTS: Reasons for non completion were categorised as due to toxicity, clinical deterioration, logistics or co-morbidities. Pre dose change 102 patients were reviewed with 6.8% stopping their treatment due to toxicity. Post dose change 74 patients were reviewed with 2.7% stopping their treatment due to toxicity CONCLUSION: This comparison suggests that the newer dose banding is equally well tolerated when compared to the older dose.
Related Links	http://dx.doi.org/10.1093/neuonc/nou249.12
Starting Page	3
File Format	PDF
ISSN	15228517
e-ISSN	15235866
Journal	Neuro-Oncology
Issue Number	Suppl 6
Volume Number	16
Language	English
Publisher	Oxford University Press
Publisher Date	2014-10-01
Access Restriction	Open
Rights Holder	Oxford University Press
Subject Keyword	Cancer Research Oncology Clinical Neurology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Cancer Research Neurology (clinical) Oncology

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P13CHANGING DOSE BANDINGS TO IMPROVE COMPLIANCE WITH TEMOZOLOMIDE CONCOMITANT WITH RADIOTHERAPY FOR HIGH GRADE GLIOMA; AN ANALYSIS OF SAFETY