Advantage of Post-Radiotherapy Chemotherapy with CCNU,Procarbazine, and Vincristine (mPCV) Over Chemotherapy with VM-26 and CCNU for Malignant Gliomas

Between 1981 and 1987, 133 patients with anaplastic astrocytoma (AA) or glioblastoma multiforme (GBM) were treated with surgery and post-operative radiotherapy. 36 AA and 31 GBM patients were treated with adjuvant chemotherapy consisting of CCNU 100 mg/m² day 1, procarbazine 60 mg/m² days 1-14, and vincristine 1.4 mg/m² (max. 2 mg) days 1 and 8, every 6 weeks which we called a «modified PCV» (mPCV) regimen. 37 AA and 29 GBM patients were treated with adjuvant chemotherapy consisting of VM-26 75 mg/m² days 1 and 2, and CCNU 60 mg/m² days 3 and 4, every 6 weeks. Prognostic covariates such as patient’s age, Karnofsky performance status score and the extent of surgery were balanced between the two treatment groups. The time to tumor progression and survival time for both regimens show that mPCV produces a two-fold increase in these factors at the 50th and 25th percentile for AA patients, but not for GBM patients, although there are more long-term GBM survivors with mPCV than with the VM-26 + CCNU regimen.