title: Phase II trial of radiotherapy after hyperbaric oxygenation with multiagent chemotherapy (procarbazine, nimustine, and vincristine) for high-grade gliomas: long-term results.
abstract: OBJECTIVE
  To analyze the long-term results of a Phase II trial of radiotherapy given immediately after hyperbaric oxygenation (HBO) with multiagent chemotherapy in adults with high-grade gliomas.
  
  
  METHODS
  Patients with histologically confirmed high-grade gliomas were administered radiotherapy in daily 2 Gy fractions for 5 consecutive days per week up to a total dose of 60 Gy. Each fraction was administered immediately after HBO, with the time interval from completion of decompression to start of irradiation being less than 15 minutes. Chemotherapy consisting of procarbazine, nimustine, and vincristine and was administered during and after radiotherapy.
  
  
  RESULTS
  A total of 57 patients (39 patients with glioblastoma and 18 patients with Grade 3 gliomas) were enrolled from 2000 to 2006, and the median follow-up of 12 surviving patients was 62.0 months (range, 43.2-119.1 months). All 57 patients were able to complete a total radiotherapy dose of 60 Gy immediately after HBO with one course of concurrent chemotherapy. The median overall survival times in all 57 patients, 39 patients with glioblastoma and 18 patients with Grade 3 gliomas, were 20.2 months, 17.2 months, and 113.4 months, respectively. On multivariate analysis, histologic grade alone was a significant prognostic factor for overall survival (p < 0.001). During treatments, no patients had neutropenic fever or intracranial hemorrhage, and no serious nonhematologic or late toxicities were seen in any of the 57 patients.
  
  
  CONCLUSIONS
  Radiotherapy delivered immediately after HBO with multiagent chemotherapy was safe, with virtually no late toxicities, and seemed to be effective in patients with high-grade gliomas.
authors.affiliation: Department of Radiology, University of the Ryukyus, Okinawa, Japan. kogawa@med.u-ryukyu.ac.jp
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Shogo
authors.initials: S
authors.lastname: Ishiuchi
authors.forename: Osamu
authors.initials: O
authors.lastname: Inoue
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yoshii
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saito
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Shiro
authors.initials: S
authors.lastname: Iraha
authors.forename: Takafumi
authors.initials: T
authors.lastname: Toita
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Kakinohana
authors.forename: Takuro
authors.initials: T
authors.lastname: Ariga
authors.forename: Goro
authors.initials: G
authors.lastname: Kasuya
authors.forename: Sadayuki
authors.initials: S
authors.lastname: Murayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001254:Astrocytoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015376:Nimustine / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D011836:Radiation Tolerance; D015173:Supratentorial Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D015376:Nimustine; D011344:Procarbazine; D014750:Vincristine