Phase III comparison of BCNU and the combination of procarbazine, CCNU, and vincristine administered after radiotherapy with hydroxyurea for malignant gliomas

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✓ The authors report the results of a randomized study conducted to evaluate the relative benefit of treatment with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) or the combination of procarbazine, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea, and vincristine (PCV) administered after radiation therapy with hydroxyurea to 76 evaluable patients with glioblastoma multiforme and 72 patients with other anaplastic gliomas. The primary end-point of the study was time to tumor progression. For better-risk patients with Karnofsky performance scores of 70 to 100, results suggest that PCV was of greater benefit than BCNU (p = 0.15 for glioblastoma multiforme; p = 0.13 for other anaplastic gliomas). Median times to tumor progression were 31 and 32 weeks for patients with glioblastoma multiforme; 25th percentile times to progression were 70 and 40 weeks for patients treated with PCV and BCNU, respectively. For patients with other anaplastic gliomas treated with PCV and BCNU, median times to progression were 123 and 77 weeks, respectively. Multivariate analysis showed that the prognostic variables of age and Karnofsky scores were important for patients with glioblastoma multiforme and other anaplastic gliomas, and that the extent of surgical resection was important for those with other anaplastic gliomas.

Article Information

Address for Mr. Resser: Cedars-Sinai Medical Center, Los Angeles, California.

Address reprint requests to: Victor A. Levin, M.D., Brain Tumor Research Center, 783 HSW, University of California, San Francisco, California 94143.

© AANS, except where prohibited by US copyright law.

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    Time to progression curves showing the probability of the tumor not progressing. Broken line = patients receiving BCNU; continuous line = patients receiving PCV. Ticks are censored patients. Left: Adequately treated glioblastoma multiforme patients with Karnofsky scores of 70 to 100. There are 30 adequately treated patients in the BCNU arm (two have not progressed) and 31 in the PCV arm (six have not progressed). Center: Adequately treated glioblastoma multiforme patients with Karnofsky scores of 40 to 60. There are 10 adequately treated patients in the BCNU arm (one has not progressed) and five in the PCV arm (all have progressed). Right: Adequately treated patients with other anaplastic gliomas with Karnofsky scores of 70 to 100. There are 33 adequately treated patients in the BCNU arm (12 have not progressed) and 33 in the PCV arm (17 have not progressed).

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