Results of a randomized trial comparing BCNU plus radiotherapy, streptozotocin plus radiotherapy, BCNU plus hyperfractionated radiotherapy, and BCNU following misonidazole plus radiotherapy in the postoperative treatment of malignant glioma

Deutsch, Melvin; Green, Sylvan B.; Strike, Thomas A.; Burger, Peter C.; Robertson, James T.; Selker, Robert G.; Shapiro, William R.; Mealey, John; Ransohoff, Joseph; Paoletti, P; Smith, Kenneth R.; Odom, Guy L.; Hunt, William E.; Young, Byron; Alexander, Eben; Walker, Michael D.; Pistenmaa, David

doi:10.1016/0360-3016(89)90939-5

Cited by 170 publications

(37 citation statements)

References 9 publications

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“…Despite surgery, radiotherapy and chemotherapy, up to 80% of patients succumb to local tumor recurrence within 2 years of diagnosis. [1][2][3][4][5] Preclinical gene therapy studies have demonstrated the potential to improve local tumor control through the delivery of therapeutic DNA constructs that encode cytotoxic or immunomodulating proteins. [6][7][8] When nonreplicating adenoviruses or retroviruses encoding herpes simplex virus thymidine kinase were used as gene therapy vectors in glioma xenograft models, tumor regression was observed.…”

Section: Introductionmentioning

confidence: 99%

Adenoviral TNF-α gene therapy and radiation damage tumor vasculature in a human malignant glioma xenograft

et al. 1998

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Section: Introductionmentioning

confidence: 99%

Adenoviral TNF-α gene therapy and radiation damage tumor vasculature in a human malignant glioma xenograft

et al. 1998

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“…[21][22][23][24] In the past, alternative regimens of radiotherapy utilizing fractionation were proposed based on the hypothesis that radiation therapy could be improved by increasing total dose or decreasing overall time of treatment. [25][26][27][28][29][30] These regimens are called "hyperfractionation"…”

Section: Discussionmentioning

confidence: 99%

“…[25][26][27][28][29][30] A few hyperfractionated or accelerated regimens of RT were tested on GBM patients, but all of the studies failed to demonstrate any improvement in the OS rate, and moreover, some neurological toxicity was reported. [25][26][27][28][29][30] Our previous studies, especially the in vitro ones, showed that daily repeated low-dose irradiation of cells, compared to a single biologically equivalent dose, resulted in significantly higher cell death. 7,17 Experiments conducted on glioma xenografts demonstrated that repeated low-dose irradiation was more effective for inhibiting tumor growth than a single large dose.…”

Section: Discussionmentioning

confidence: 99%

A concurrent ultra‐fractionated radiation therapy and temozolomide treatment: A promising therapy for newly diagnosed, inoperable glioblastoma

Beauchesne

Quillien

Faure

et al. 2015

Intl Journal of Cancer

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We report on a phase II clinical trial to determine the effect of a concurrent ultra-fractionated radiotherapy and temozolomide treatment in inoperable glioblastoma patients. A phase II study opened; patients over 18 years of age who were able to give informed consent and had histologically proven, newly diagnosed inoperable diagnosed and supratentorial glioblastoma were eligible. Three doses of 0.75 Gy spaced apart by at least 4 hr were delivered daily, 5 days a week for six consecutive weeks for a total of 67.5 Gy. Chemotherapy was administered during the same period, which consisted of temozolomide given at a dose of 75 mg/m 2 for 7 days a week. After a 4-week break, chemotherapy was resumed for up to six cycles of adjuvant temozolomide treatment, given every 28 days, according to the standard 5-day regimen. Tolerance and toxicity were the primary endpoints; survival and progression-free survival were the secondary endpoints. In total, 40 patients were enrolled in this study, 29 men and 11 women. The median age was 58 years, and the median Karnofsky performance status was 80. The concomitant ultra-fractionated radiotherapy and temozolomide treatment was well tolerated. Complete responses were seen in four patients, and partial responses were reported in seven patients. The median survival from the initial diagnosis was 16 months. Several long-term survivors were noted. Concurrent ultra-fractionated radiation therapy and temozolomide treatment are well accepted by the patients. The results showed encouraging survival rates for these unfavorable patients.Glioblastoma (GBM) is the most common primary brain tumor in adults and is characterized by a high rate of local recurrences because of its intrinsic radioresistance. 1-4 Indeed, GBM is considered one of the most radioresistant tumors.

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“…Glioblastoma possesses coagulation necrosis and its prognosis is worse than astrocytoma grade III (Nelson et al 1983;Deutsch et al 1989; Shapiro et al 1989;Sandeman et al 1990). However, the specimens by stereotactic biopsy are not enough to judge the integral nature of a tumor, and in some cases we must start radiation therapy without any histopathological proof.…”

mentioning

confidence: 99%

Prognostic Significance of CT Scan in Malignant Glioma.

Yamada

Takai

Nemoto

et al. 1993

Tohoku J. Exp. Med.

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In 91 malignant gliomas treated with radiation therapy, CT scan which was taken before treatment was reviewed to examine the significance as a prognostic indicator. The irradiation methods and the surgical resectability did not affect the survival. Similarly, the tumor location and the grade of the low density area (LDA) surrounding the contrast enhanced area (CEA) had no significance on the prognosis. As a result of the multi-variate analysis, the histopathologic diagnosis, the CEA size and the CEA pattern were significantly important prognostic factors. Astrocytoma grade III, a CEA diameter of under 4 cm and a homogeneous CEA were favorable indicators of the malignant gliomas. Tumors with a heterogeneous or a ring-like CEA in the diameter of more than 4 cm have the worse prognosis and should be treated extensively by radiation therapy. brain neoplasm; malignant glioma; CT; therapeutic radiology; prognostic factor

show abstract

Results of a randomized trial comparing BCNU plus radiotherapy, streptozotocin plus radiotherapy, BCNU plus hyperfractionated radiotherapy, and BCNU following misonidazole plus radiotherapy in the postoperative treatment of malignant glioma

Cited by 170 publications

References 9 publications

Adenoviral TNF-α gene therapy and radiation damage tumor vasculature in a human malignant glioma xenograft

Adenoviral TNF-α gene therapy and radiation damage tumor vasculature in a human malignant glioma xenograft

A concurrent ultra‐fractionated radiation therapy and temozolomide treatment: A promising therapy for newly diagnosed, inoperable glioblastoma

Prognostic Significance of CT Scan in Malignant Glioma.

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