Malignant astrocytoma: hyperfractionated and standard radiotherapy with chemotherapy in a randomized prospective clinical trial
A prospective randomized trial of 157 patients with malignant astrocytomas (Grade III or IV) was carried out at a single institution. The minimization technique ensured balanced distribution of prognostic factors between the treatment groups. All received oral lomustine (CCNU, 80 mg/m/sup 2/) six weekly and hydroxyurea (HU, 3.5 gm/m/sup 2/ over 5 days) three weekly, for one year or until recurrence, with doses adjusted for myelosuppression. Patients were randomized to daily (5000 rad in 25 fractions (fr) in 5 weeks) or Q3h (every 3 hours) Cobalt 60 irradiation (3600-4000 rad in 36-40 fr of 100 rad each, given 4 fr per day at 3-hour intervals over two weeks). Steroid therapy (up to 16 mg day dexamethasone) was permitted. Complications were moderate and equivalent in the two groups. No significant survival or toxicity differences were seen between the two groups. Age, initial performance status, and extent of surgical resection were found to be significant (P<0.01) prognostic factors for survival. Median survival of the whole group was 48 weeks with a minimum follow-up of one year. There was no advantage to large radiation fields. The hyperfractionation and daily regimes had similar efficacy and toxicity. Hyperfractionation with chemotherapy offers a useful alternative approach in the management of this disease.
- Research Organization:
- Princess Margaret Hospital, Toronta, Ontario, Canada
- OSTI ID:
- 6426138
- Journal Information:
- Cancer (Philadelphia); (United States), Vol. 50:11
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
ASTROCYTOMAS
RADIOTHERAPY
BRAIN
FRACTIONATED IRRADIATION
COMPARATIVE EVALUATIONS
SIDE EFFECTS
CHEMOTHERAPY
COBALT 60
PATIENTS
RADIODERMATITIS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
CENTRAL NERVOUS SYSTEM
COBALT ISOTOPES
DERMATITIS
DISEASES
GLIOMAS
INJURIES
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
IRRADIATION
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LOCAL RADIATION EFFECTS
MEDICINE
MINUTES LIVING RADIOISOTOPES
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
ORGANS
RADIATION EFFECTS
RADIATION INJURIES
RADIOISOTOPES
RADIOLOGY
SKIN DISEASES
THERAPY
YEARS LIVING RADIOISOTOPES
560151* - Radiation Effects on Animals- Man