title: Combination chemotherapy with carmustine and cisplatin before, during, and after radiotherapy for adult malignant gliomas.
abstract: Twenty-two patients, aged 16 to 67, who had malignant gliomas after surgical resection were treated with carmustine and cisplatin intravenous infusion before, during, and after radiotherapy. All patients had subtotal or total resection, or biopsy as the initial procedure. Twenty-one patients who had at least 2 cycles of chemotherapy and finished the whole course of radiotherapy were considered to be evaluable for responses. Among them, 5 had glioblastoma multiforme, 16 had anaplastic astrocytoma. The median time to tumor progression was 35 weeks (range 12-130 weeks) and median survival time was 66 weeks (range 10-156 weeks). Early progression occurred more frequently in patients with biopsy only and subtotal resection, and in patients with glioblastoma than in those with anaplastic astrocytoma. This combined modality treatment program was associated with reversible hematologic toxicity which was severe in 2 patients, and with ototoxicity in 1 patient, nephrotoxicity in 2 patients. Combination of carmustine and cisplatin with cranial irradiation for malignant gliomas is moderately toxic and appears to offer no obvious survival advantage compared with radiation therapy plus BCNU alone.
authors.affiliation: Division of Hematology-Oncology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
authors.forename: M C
authors.initials: MC
authors.lastname: Kiu
authors.forename: C N
authors.initials: CN
authors.lastname: Chang
authors.forename: W C
authors.initials: WC
authors.lastname: Cheng
authors.forename: T K
authors.initials: TK
authors.lastname: Lin
authors.forename: C W
authors.initials: CW
authors.lastname: Wong
authors.forename: S G
authors.initials: SG
authors.lastname: Tang
authors.forename: W M
authors.initials: WM
authors.lastname: Leung
authors.forename: L H
authors.initials: LH
authors.lastname: Chen
authors.forename: Y S
authors.initials: YS
authors.lastname: Ho
authors.forename: K T
authors.initials: KT
authors.lastname: Ng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D002945:Cisplatin; D002330:Carmustine