Malignant gliomas treated with split course radiotherapy plus chemotherapy

Area of Science:

• Neuro-oncology
• Radiation Oncology
• Medical Oncology

Background:

• Malignant gliomas, including astrocytoma and glioblastoma multiforme, are aggressive brain tumors.
• Optimal treatment strategies for malignant gliomas are continuously being investigated to improve patient survival.

Purpose of the Study:

• To evaluate the efficacy of combined modality treatment using split-course radiotherapy (sRT) with nimustine hydrochloride (ACNU) and tegafur (FT) in adult patients with supratentorial malignant gliomas.
• To compare the survival outcomes of this combined modality approach against historical controls receiving continuous-course radiotherapy (cRT) with or without chemotherapy.

Main Methods:

• A cohort of 25 adult patients with histologically verified supratentorial malignant gliomas received postoperative sRT (30 Gy whole brain followed by a 50-60 Gy boost) combined with ACNU and FT.
• Treatment outcomes were compared to historical control groups who received cRT alone or with chemotherapy prior to 1979 and after 1986.
• Kaplan-Meier survival analysis and the generalized Wilcoxon test were employed for statistical comparison.

Main Results:

• The median survival time (MST) for patients receiving sRT plus chemotherapy was 18 months.
• Historical control groups showed MSTs of 12 months for cRT alone and 13 months for cRT plus chemotherapy.
• No statistically significant differences in survival curves were observed between the sRT plus chemotherapy group and the cRT control groups.

Conclusions:

• The combined modality treatment of split-course radiotherapy with nimustine hydrochloride and tegafur did not demonstrate a significant survival benefit over continuous-course radiotherapy for supratentorial malignant gliomas.
• Patient age, Karnofsky performance status, and tumor histology were identified as significant prognostic factors influencing survival in malignant glioma patients.