The role of chemotherapy in anaplastic astrocytoma patients.
OBJECTIVE
This retrospective study was performed to evaluate the role of chemotherapy in the management of patients with anaplastic astrocytoma (AA).


METHODS
We compared the survival outcome among the 3 different treatment protocol groups in a single institution. A total of 86 patients (39 men and 47 women) with newly diagnosed AA after surgery were analyzed. Among them, 31 patients (36.0%) were treated with radiotherapy only (RT Group), 30 patients (34.9%) were treated with nimustine-cisplatin chemotherapy before RT (ACNU-CDDP group), and 25 patients (29.1%) were treated with procarbazine, lomustine and vincristine (PCV) chemotherapy after radiotherapy (PCV group).


RESULTS
The median survival was 14.0, 30.0 and 72.0 months in RT, ACNU-CDDP, and PCV group, respectively and showed significant differences (RT vs. ACNU-CDDP; p=0.039, RT vs. PCV; 0.002, ACNU-CDDP vs. PCV; 0.045). PCV group showed less toxicity rate (5 patients; 20%) than ACNU-CDDP group (12 patients; 40%), while only 3 patients (9.6%) in RT group experienced grade 3 or 4 toxicities.


CONCLUSIONS
An application of chemotherapy before or after radiotherapy is beneficial in prolonging the survival of patients with AA. Adjuvant PCV chemotherapy after radiotherapy is recommendable.
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
Sung Kwon
SK
Kim
Jin Wook
JW
Kim
Yong Hwy
YH
Kim
Tae Min
TM
Kim
Se-Hoon
SH
Lee
Chul-Kee
CK
Park