Malignant gliomas treated with split course radiotherapy plus chemotherapy

Twenty-five adult patients with supratentorial malignant gliomas (malignant astrocytoma and glioblastoma multiforme) verified histologically from 1979 to 1986 postoperatively received combined modalities of split course radiotherapy (sRT), nimustine hydrochloride (ACNU), and tegafur (FT). The initial course of radiation consisted of 30 Gy whole brain in 15 fractions five days a week. After a one-week interruption, local radiation with a limited field including a tumor and a margin was boosted to a total dose of about 50-60 Gy. The results were compared with historical control comprising malignant gliomas which received continuous course of radiotherapy (cRT) with or without other chemotherapy before 1979 and after 1986. The median survival time (MST) of malignant gliomas was 18 months for sRT plus chemotherapy, 12 months for cRT alone, and 13 months for cRT plus chemotherapy. No differences between the Kaplan-Meier survival curves were significant by the generalized Wilcoxon test. Tumor histology, Karnofsky performance status, and patient age related well with survival.