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Single versus multiple drug therapy in the combined treatment of malignant gliomas. A multicenter study.

Abstract
The best treatment of malignant gliomas has been considered to be surgery followed by irradiation and chemotherapy with nitrosourea compounds. Our controlled and randomized trial was designed in 1982 to analyze the effectiveness of multiple-drug versus single-drug therapy in patients bearing malignant gliomas. After 3 weeks from surgery and histopathological diagnosis 173 patients were randomly assigned to receive one of the three chemotherapy regimens: CCNU alone, CCNU plus VM-26 or CCNU plus VM-26 plus 5-FU. Radiotherapy was administered whole-brain (40-45 Gy) and coned-down focal (15-20 Gy) irradiation for a total of 60 Gy (1700 rets) in conjunction with the first course of chemotherapy. 150/173 patients are evaluable. Statistical analysis of results shows a better quality of life and survival for patients treated with polychemotherapy using a three drug combination than two drug or single drug therapy (13.8 vs 14.7 vs 18.2 months MST; P less than 0.01) but with a higher incidence of toxicity problems. An analysis of prognostic factors and their distribution in each arm of the protocol will be made in the near future.
AuthorsR Knerich, D Adinolfi, F Giunta, P Buoncristiani, P Gaetani, R Assietti, F D'Ettorre, G Butti, D Schiffer
JournalJournal of neurosurgical sciences (J Neurosurg Sci) 1990 Jul-Dec Vol. 34 Issue 3-4 Pg. 251-5 ISSN: 0390-5616 [Print] Italy
PMID1965904 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Lomustine
  • Teniposide
  • Fluorouracil
Topics
  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Astrocytoma (drug therapy)
  • Brain Neoplasms (drug therapy)
  • Female
  • Fluorouracil (administration & dosage)
  • Glioblastoma (drug therapy)
  • Humans
  • Lomustine (administration & dosage, therapeutic use)
  • Male
  • Middle Aged
  • Teniposide (administration & dosage)

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