[Chemotherapy of malignant glioma. Results of studies of the EORTC group of brain tumors]

Abstract

The EORTC Brain Tumor Group has conducted 5 randomized and prospective phase-III trials in adults with supratentorial malignant gliomas testing the following adjuvant treatments: 1) CCNU 130 mg/m2, q.6 weeks (trial 26741); 2) VM-26 100 mg/m2 on day 1, plus CCNU 130 mg/m2 on day 2, q.6 weeks, given either during radiation therapy (trial 26751) or during 12 weeks prior to irradiation (trial 26841); 3) Misonidazole 12 mg/m2 total dose in 9 fractions (trial 26801); 4) Cisplatin 60 mg/m2 on days 1, 8, 15 and 21 of radiation therapy (trial 26851). None of these treatments did prolong significantly the survival nor the time to recurrence. The most powerful prognostic factors found in every trial were tumor pathology, patients' age and neurological status. Objective remission lasting 6 to 9 months, defined as a clinical improvement persisting after discontinuation of corticosteroids, was observed with CCNU, VM26 plus CCNU or HeCNU in approximately 20% of the patients, while 30% stabilized on HeCNU. The activity of procarbazine, AZQ or DDMP used as single agents was much lower.