title: Advantage of treating anaplastic gliomas with aggressive protocol combining chemotherapy and radiotherapy.
abstract: We devised a treatment protocol for anaplastic gliomas consisting of:(a) chemotherapy prior to radiotherapy (b) a second chemotherapy regimen at tumor recurrence (c) repeated surgery whenever possible. 41 Anaplastic Astrocytoma (AA), 16 Anaplastic oligoastrocytoma (AOA) and 14 anaplastic oligodendroglioma (AOD) patients were treated. After surgery all patients received 5-6 cycles of carmustine+Cisplatinum chemotherapy. Radiotherapy was started during the last 2-3 cycles of chemotherapy. 17 patients (30.5%) were reoperated on at recurrence. All recurring patients underwent PVC chemotherapy. At this moment disease recurred in 56 patients. Median TTP was 24.5, 38.7 and 58.2 months for AA, AOA and AOD respectively. Median ST was 38.8, 71.8 and 73 months. In conclusion our sandwich protocol of prior chemotherapy, overlapping irradiation with second chemotherapy and, in favourable cases, a second surgical intervention, is of benefit in patients with anaplastic gliomas.
authors.affiliation: Istituto Nazionale Neurologico Besta, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Boiardi
authors.forename: A
authors.initials: A
authors.lastname: Silvani
authors.forename: A
authors.initials: A
authors.lastname: Pozzi
authors.forename: M
authors.initials: M
authors.lastname: Farinotti
authors.forename: L
authors.initials: L
authors.lastname: Fariselli
authors.forename: G
authors.initials: G
authors.lastname: Broggi
authors.forename: A
authors.initials: A
authors.lastname: Salmaggi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001254:Astrocytoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002330:Carmustine / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005910:Glioma / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D002945:Cisplatin; D002330:Carmustine