Comparisons of carmustine, procarbazine, and high-dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma

S. B. Green, D. P. Byar, M. D. Walker, D. A. Pistenmaa, E. Alexander, U. Batzdorf, W. H. Brooks, W. E. Hunt, J. Mealey, G. L. Odom, P. Paoletti, J. Ransohoff, J. T. Robertson, R. G. Selker, W. R. Shapiro, K. R. Smith, C. B. Wilson, T. A. Strike

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362 Citations (Scopus)

Abstract

Within 3 weeks of definitive surgery, 609 patients with histologically demonstrated, supratentorial malignant glioma were randomized to receive, in addition to 6000 rads of radiotherapy, one of four treatment regimens: carmustine (BCNU), high-dose methylprednisolone, procarbazine, or BCNU plus high-dose methylprednisolone. We analyzed the data for the total randomized population and for the 527 patients (87% with glioblastoma multiforme) in whom the initial protocol specifications were met (the valid study group). Significantly longer survival was experienced by patients receiving procarbazine or BCNU alone compared to those receiving only high-dose methylprednisolone. No other pairwise comparisons demonstrated differences significant at the 0.05 level. However, the combination of BCNU plus high-dose methylprednisolone tended to be less effective than BCNU alone in patients with poor prognosis. This study indicates that BCNU and procarbazine are moderately useful agents in conjunction with radiotherapy for patients with malignant glioma. In addition, future protocols may allow use of corticosteroids in conventional dosages for treating cerebral edema and controlling symptoms; conclusions based on survival as the endpoint are unlikely to be affected by administering steroids at somewhat greater than the usual dose. More effective regimens for the treatment of malignant glioma should be sought.

Original languageEnglish (US)
Pages (from-to)121-132
Number of pages12
JournalCancer Treatment Reports
Volume67
Issue number2
StatePublished - 1983

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Procarbazine
Carmustine
Methylprednisolone
Glioma
Radiotherapy
Therapeutics
Survival
Brain Edema
Glioblastoma
Adrenal Cortex Hormones
Steroids

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Green, S. B., Byar, D. P., Walker, M. D., Pistenmaa, D. A., Alexander, E., Batzdorf, U., ... Strike, T. A. (1983). Comparisons of carmustine, procarbazine, and high-dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma. Cancer Treatment Reports, 67(2), 121-132.

Comparisons of carmustine, procarbazine, and high-dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma. / Green, S. B.; Byar, D. P.; Walker, M. D.; Pistenmaa, D. A.; Alexander, E.; Batzdorf, U.; Brooks, W. H.; Hunt, W. E.; Mealey, J.; Odom, G. L.; Paoletti, P.; Ransohoff, J.; Robertson, J. T.; Selker, R. G.; Shapiro, W. R.; Smith, K. R.; Wilson, C. B.; Strike, T. A.

In: Cancer Treatment Reports, Vol. 67, No. 2, 1983, p. 121-132.

Research output: Contribution to journalArticle

Green, SB, Byar, DP, Walker, MD, Pistenmaa, DA, Alexander, E, Batzdorf, U, Brooks, WH, Hunt, WE, Mealey, J, Odom, GL, Paoletti, P, Ransohoff, J, Robertson, JT, Selker, RG, Shapiro, WR, Smith, KR, Wilson, CB & Strike, TA 1983, 'Comparisons of carmustine, procarbazine, and high-dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma', Cancer Treatment Reports, vol. 67, no. 2, pp. 121-132.
Green, S. B. ; Byar, D. P. ; Walker, M. D. ; Pistenmaa, D. A. ; Alexander, E. ; Batzdorf, U. ; Brooks, W. H. ; Hunt, W. E. ; Mealey, J. ; Odom, G. L. ; Paoletti, P. ; Ransohoff, J. ; Robertson, J. T. ; Selker, R. G. ; Shapiro, W. R. ; Smith, K. R. ; Wilson, C. B. ; Strike, T. A. / Comparisons of carmustine, procarbazine, and high-dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma. In: Cancer Treatment Reports. 1983 ; Vol. 67, No. 2. pp. 121-132.
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abstract = "Within 3 weeks of definitive surgery, 609 patients with histologically demonstrated, supratentorial malignant glioma were randomized to receive, in addition to 6000 rads of radiotherapy, one of four treatment regimens: carmustine (BCNU), high-dose methylprednisolone, procarbazine, or BCNU plus high-dose methylprednisolone. We analyzed the data for the total randomized population and for the 527 patients (87{\%} with glioblastoma multiforme) in whom the initial protocol specifications were met (the valid study group). Significantly longer survival was experienced by patients receiving procarbazine or BCNU alone compared to those receiving only high-dose methylprednisolone. No other pairwise comparisons demonstrated differences significant at the 0.05 level. However, the combination of BCNU plus high-dose methylprednisolone tended to be less effective than BCNU alone in patients with poor prognosis. This study indicates that BCNU and procarbazine are moderately useful agents in conjunction with radiotherapy for patients with malignant glioma. In addition, future protocols may allow use of corticosteroids in conventional dosages for treating cerebral edema and controlling symptoms; conclusions based on survival as the endpoint are unlikely to be affected by administering steroids at somewhat greater than the usual dose. More effective regimens for the treatment of malignant glioma should be sought.",
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AU - Byar, D. P.

AU - Walker, M. D.

AU - Pistenmaa, D. A.

AU - Alexander, E.

AU - Batzdorf, U.

AU - Brooks, W. H.

AU - Hunt, W. E.

AU - Mealey, J.

AU - Odom, G. L.

AU - Paoletti, P.

AU - Ransohoff, J.

AU - Robertson, J. T.

AU - Selker, R. G.

AU - Shapiro, W. R.

AU - Smith, K. R.

AU - Wilson, C. B.

AU - Strike, T. A.

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