Radiation therapy combined with radiosensitizing agents for cerebral glioblastoma in adults |
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Authors: | Masao Matsutani Osamu Nakamura Masanao Nakamura Tadashi Nagashima Akio Asai Takamitsu Fujimaki Hideki Tanaka Keisuke Ueki Yoshiaki Tanaka |
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Institution: | (1) Department of Neurosurgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan;(2) Department of Radiation Therapy, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan;(3) Department of Neurosurgery, Saitama Medical School, Moroyamacho, Morohongo 38, Irumagun, Saitama, Japan |
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Abstract: | We analyzed our treatment results of 71 operated patients with cerebral glioblastoma treated by conventional external radiation therapy (mean dose 60.2 Gy) combined with radiosensitizing agents. More than 50% reduction of tumor volume was obtained in 20 patients (28.2%). A response rate of at least 40% was obtained in patients treated with combined ACNU-vincristine-nicardipine, ACNU-5FU-hydroxyurea, or cisplatin alone. The combination of ACNU and vincristine with or without nicardipine resulted in significantly longer survival. The median survival in this group was 101.1 weeks and the two-year survival rate was 45.9%; these results were significantly better than those achieved with other ACNU combinations or other combinations without ACNU. In the analysis of survival, factors correlated to longer survival were a patient age of younger than 45 years, wide resection of the tumor, a good postoperative performance status (KS 70%), a radiation dose of 68–72 Gy, small postoperative tumor remnants (< 20 cm3), no visible tumor after radiation therapy, and the administration of adjuvant chemotherapy. Maximum resection of the tumor and localized irradiation with a dose of 70 Gy combined with ACNU and vincristine appears to be the most effective treatment at present. |
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Keywords: | glioblastoma brain tumor radiation therapy chemotherapy ACNU |
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