Efficiency of the radio-chemo-surgical. Treatment in cerebral astrocytomas

This paper reports on the evaluation of 29 patients with I-st grade, 35 patients with II-nd grade astrocytomas and 145 patients with malignant astrocytomas (gr. III or IV) with a postoperative Karnofski index of minimum 60, treated with wide surgical resections, chemotherapy (CCNU 130 mg/m2 body surface) and irradiation with 60Co or conventional roentgen-therapy, in doses of 50-60 Gy, fractionated applied. The control group was formed by patients treated surgically and by postoperative irradiation: 5 with I-st and II-nd grade astrocytomas and 30 with malignant ones. Comparison of the results shows a median survival of 71.5 weeks for I-st grade, 66.5 weeks for II-nd grade and 44 weeks for high malignant astrocytomas treated only with CCNU, as against 150, 119 and respectively 73 weeks when chemotherapy was associated with irradiation with 60Co. The statistical differences between the results of radiochemotherapy and the cobalt-therapy applied alone were also very significant. The long-term survival: at 5 years for I-st and II-nd degree and at 1 and 3 year for malignant astrocytomas revealed the same superiority of the complex associated treatment (radio-chemo-surgical). No significant differences in survival were recorded in relation to age, sex and site in surgically treatable cases. However the infiltrative character of the tumors significantly aggravate the prognosis. It is concluded that association of chemotherapy with cobalt-therapy postoperatively brings about a statistical significant increase in survival as against postoperative chemotherapy or irradiation applied alone.