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The management of lomustine overdose in malignant glioma patients
Hans-Georg Wirsching1, Isabel Tritschler1, Antonella Palla1
1Department of Neurology, University Hospital Zurich, Zurich, Switzerland (H.-G.W., I.T., A.P., M.W., G.T.); Department of Medical Oncology , University Hospital Zurich , Zurich , Switzerland (C.R.); Neuroscience Center Zurich , University of Zurich and ETH Zurich , Zurich , Switzerland (H.-G.W., I.T., A.P., M.W., G.T.).
Abstract:
Lomustine is an oral alkylating drug commonly used for brain tumor patients. Recently, the lomustine-containing PCV polychemotherapy regime (procarbazine, CCNU/lomustine, and vincristine) in combination with radiotherapy has become the standard of care for anaplastic oligodendroglioma with 1p/19q codeletion and high-risk low-grade glioma. Here, we review the literature of all reported cases of lomustine overdose, highlight complications by exemplifying a case of inadvertent lomustine overdose, and outline the management of this potential complication of outpatient PCV therapy.
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