Results of a randomized trial comparing BCNU plus radiotherapy, streptozotocin plus radiotherapy, BCNU plus hyperfractionated radiotherapy, and BCNU following misonidazole plus radiotherapy in the postoperative treatment of malignant glioma

Melvin Deutsch, Sylvan B. Green, Thomas A. Strike, Peter C. Burger, James T. Robertson, Robert G. Selker, William R. Shapiro, John Mealey, Joseph Ransohoff, Pietro Paoletti, Kenneth R. Smith, Guy L. Odom, William E. Hunt, Byron Young, Eben Alexander, Michael D. Walker, David A. Pistenmaa

Research output: Contribution to journalArticle

Abstract

In Brain Tumor Cooperative Group Study 77-02, eleven institutions randomized 603 adult patients with supratentorial malignant glioma to one of four treatment groups following surgery: conventional radiotherapy (6000 cGy in 30-35 fractions) + BCNU, conventional radiotherapy + streptozotocin, hyperfractionated (twice daily) radiotherapy (6600 cGy in 60 fractions) + BCNU, and conventional radiotherapy with misonidazole followed by BCNU. Data were analyzed for the total randomized population and for the 557 patients (86% with glioblastoma multiforme) who met protocol eligibility specifications (including confirmed histopathology on central review). Median survival was approximately 10 months following randomization. Overall there was no statistically significant difference in survival among the four groups. Among non-glioblastoma patients, the misonidazole group appeared to have poor survival. Peripheral neuropathy was a dose-limiting toxicity with misonidazole. It is concluded that neither the addition of misonidazole nor hyperfractionated radiotherapy as given in this protocol offered any advantage over conventional radiotherapy plus either BCNU or streptozotocin for treatment of malignant glioma.

Original languageEnglish (US)
Pages (from-to)1389-1396
Number of pages8
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume16
Issue number6
DOIs
StatePublished - 1989
Externally publishedYes

Fingerprint

Misonidazole
Carmustine
Streptozocin
Glioma
radiation therapy
Radiotherapy
Survival
Therapeutics
Peripheral Nervous System Diseases
Glioblastoma
Random Allocation
surgery
Brain Neoplasms
toxicity
brain
specifications
tumors
dosage
Population

Keywords

  • Chemotherapy
  • Glioblastoma multiforme
  • Hyperfractionation
  • Malignant glioma
  • Radiosensitizers
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Results of a randomized trial comparing BCNU plus radiotherapy, streptozotocin plus radiotherapy, BCNU plus hyperfractionated radiotherapy, and BCNU following misonidazole plus radiotherapy in the postoperative treatment of malignant glioma. / Deutsch, Melvin; Green, Sylvan B.; Strike, Thomas A.; Burger, Peter C.; Robertson, James T.; Selker, Robert G.; Shapiro, William R.; Mealey, John; Ransohoff, Joseph; Paoletti, Pietro; Smith, Kenneth R.; Odom, Guy L.; Hunt, William E.; Young, Byron; Alexander, Eben; Walker, Michael D.; Pistenmaa, David A.

In: International Journal of Radiation Oncology, Biology, Physics, Vol. 16, No. 6, 1989, p. 1389-1396.

Research output: Contribution to journalArticle

Deutsch, M, Green, SB, Strike, TA, Burger, PC, Robertson, JT, Selker, RG, Shapiro, WR, Mealey, J, Ransohoff, J, Paoletti, P, Smith, KR, Odom, GL, Hunt, WE, Young, B, Alexander, E, Walker, MD & Pistenmaa, DA 1989, 'Results of a randomized trial comparing BCNU plus radiotherapy, streptozotocin plus radiotherapy, BCNU plus hyperfractionated radiotherapy, and BCNU following misonidazole plus radiotherapy in the postoperative treatment of malignant glioma', International Journal of Radiation Oncology, Biology, Physics, vol. 16, no. 6, pp. 1389-1396. https://doi.org/10.1016/0360-3016(89)90939-5
Deutsch, Melvin ; Green, Sylvan B. ; Strike, Thomas A. ; Burger, Peter C. ; Robertson, James T. ; Selker, Robert G. ; Shapiro, William R. ; Mealey, John ; Ransohoff, Joseph ; Paoletti, Pietro ; Smith, Kenneth R. ; Odom, Guy L. ; Hunt, William E. ; Young, Byron ; Alexander, Eben ; Walker, Michael D. ; Pistenmaa, David A. / Results of a randomized trial comparing BCNU plus radiotherapy, streptozotocin plus radiotherapy, BCNU plus hyperfractionated radiotherapy, and BCNU following misonidazole plus radiotherapy in the postoperative treatment of malignant glioma. In: International Journal of Radiation Oncology, Biology, Physics. 1989 ; Vol. 16, No. 6. pp. 1389-1396.
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abstract = "In Brain Tumor Cooperative Group Study 77-02, eleven institutions randomized 603 adult patients with supratentorial malignant glioma to one of four treatment groups following surgery: conventional radiotherapy (6000 cGy in 30-35 fractions) + BCNU, conventional radiotherapy + streptozotocin, hyperfractionated (twice daily) radiotherapy (6600 cGy in 60 fractions) + BCNU, and conventional radiotherapy with misonidazole followed by BCNU. Data were analyzed for the total randomized population and for the 557 patients (86{\%} with glioblastoma multiforme) who met protocol eligibility specifications (including confirmed histopathology on central review). Median survival was approximately 10 months following randomization. Overall there was no statistically significant difference in survival among the four groups. Among non-glioblastoma patients, the misonidazole group appeared to have poor survival. Peripheral neuropathy was a dose-limiting toxicity with misonidazole. It is concluded that neither the addition of misonidazole nor hyperfractionated radiotherapy as given in this protocol offered any advantage over conventional radiotherapy plus either BCNU or streptozotocin for treatment of malignant glioma.",
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