Impact of adjuvant chemotherapy for gliomatosis cerebri.
BACKGROUND
Gliomatosis cerebri (GC) is characterized by a diffuse infiltration of tumor cells throughout CNS, however, few details are available about the chemotherapeutic effect on GC. The aim of this study was to investigate its clinical course and to determine the efficacy of chemotherapy for GC.


METHODS
Between Jan. 1999 and Dec. 2004, 37 GC patients were diagnosed by biopsy and treated with radiotherapy in a single institution. To determine the efficacy of chemotherapy for GC, we retrospectively reviewed their clinical courses. The study cohort was divided into 2 groups, those with and without receiving post-radiotherapy adjuvant chemotherapy such as temozolomide or nitrosourea-based chemotherapy.


RESULTS
Nineteen patients with adjuvant chemotherapy were assigned to the chemotreatment group and 18 with radiotherapy alone were assigned to the control group. Mean survival for chemotreatment group and control group were 24.2 and 13.1 months, respectively (p = 0.045). Time to progression for these groups were 16.0 and 6.0 months, respectively (p = 0.007). Overall review of the clinical course of patients with GC provided that early appearance of new contrast-enhancing lesions within 6 months from the initial diagnosis and higher histological grade were closely associated with poor survival (p < 0.001 and p = 0.008).


CONCLUSIONS
Adjuvant chemotherapy following radiotherapy could prolong the survival in patients with GC. In addition, newly developed contrast-enhanced lesions on the follow-up MR images indicate the progression of GC.
Kong
Doo-Sik
DS
Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim
Sung Tae
ST
Lee
Jung-Il
JI
Suh
Yeon-Lim
YL
Lim
Do Hoon
DH
Kim
Won Seog
WS
Kwon
Ki-Hoon
KH
Park
Kwan
K
Kim
Jong Hyun
JH
Nam
Do-Hyun
DH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000150:complications* / Q000473:pathology / Q000532:radiotherapy*; D002330:Carmustine / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002648:Child; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018302:Neoplasms, Neuroepithelial / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D011344:Procarbazine / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D000077204:Temozolomide; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine; D003606:Dacarbazine; D002330:Carmustine; D000077204:Temozolomide