Radiotherapy and chemotherapy of malignant brain gliomas

At present radiation therapy appears to be the only effective adjuvant treatment in malignant supratentorial gliomas (MSG). Six thousand rads given over 6 weeks increase survival significantly, by about 50%, but the addition of a further 1000 rads to the conventional 6000 rad dose may not be beneficial. Radiosensitizers of anoxic cells such as mizonidazole are ineffective. Superfractionation could represent an improvement over conventional radiotherapy. Adjuvant chemotherapy has proved ineffective in the vast majority of trials, with a few exceptions, the most important being the increase of long-term survivors by BCNU. In the author's opinion chemotherapy should be restricted to patients with recurring signs of MSG.