Abstract
Phase III Trial 8301 compared intra-arterial (IA) versus intravenous (IV) BCNU (200 mg/m2 q 8 wk), each regimen without or with IV 5-FU (1 g/m2/d × 3 two wks after BCNU), plus radiation therapy, in the treatment of malignant glioma. Actuarial analysis (logrank) demonstrated worse survival for the IA group (p=0.07, and for those receiving at least one course, p=0.03). Serious toxicity was observed in the IA group, including irreversible encephalopathy (8.4%) and visual loss ipsilateral to the infused carotid artery. 5-FU did not influence survival. IA BCNU is neither safe nor effective. Phase II Trial 8420, compared IA cisplatin, 60 mg/m2 every 4 weeks, versus IV PCNU, 100 mg/m2 every 8 weeks. There was no statistical difference in survival between patients treated with IV PCNU and those treated with IA cisplatin. The median survival of the IV PCNU patients was 11.8 months; that of the IA cisplatin patients was 9.4 months. The incidence of encephalopathy was substantially less than with IA BCNU; the incidence of severe encephalopathy was 1.3%.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Walker, M.D., Alexander, E. Jr., Hunt, W.E., et al. (1978) Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J. Neurosurg. 49, 333–343.
Walker, M.D., Green, S.B., Byar, D.P., et al. (1980) Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. New Engl. J. Med. 303, 1323–1329.
Shapiro, W.R., Green, G.B., Burger, P.C., et al. (1989) Randomized trial of three chemotherapy regimens and two radiotherapy regimens in postoperative treatment of malignant glioma: Brain Tumor Cooperative Group Trial 8001. J. Neurosurg. 71, 1–9.
Gutin, P.H., Leibel, S.A., Wara, W.M., et al. (1987) Recurrent malignant gliomas: survival following interstitial brachytherapy with high-activity iodine-125 sources. J. Neurosurg. 67, 864–873.
Green, S.B., Byar, D.P., Walker, M.D., et al. (1983) Comparisons of carmustine, procarbazine, and high dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma. Cancer Treat. Rep. 67, 121–132.
Shapiro, W.R. and Green, S.B. (1987) Neurosurgical Forum, Letter to the editor: Reevaluating the efficacy of intraarterial BCNU. J. Neurosurg. 66, 313–315.
Shapiro, W.R., Green, S.B., Burger, P.C., et al. (1987) A randomized comparison of intraarterial (IA) vs. intravenous (IV) BCNU for patients with malignant glioma (Study 8301): interim analysis demonstrating lack of efficacy for IA BCNU. Proc. Am. Soc. Clin, Oncol. 6, 69.
Green, S.B., Shapiro, W.R., Burger, P.C., et al. (1989) Randomized comparison of intraarterial (IA) cisplatin and intravenous (IV) PCNU for the treatment of primary brain tumors (BTCG Study 8420A). Proc. Amer. Soc. Clin. Oncol. 8, 86.
Rosenblum, M.D., Delattre, J-Y., Walker, R.W., and Shapiro, W.R. (1989) Fatal necrotizing encephalopathy complicating treatment of malignant gliomas with intra-arterial BCNU and irradiation: a pathological study. J. Neuro-Oncology 7, 269–281.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1991 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Shapiro, W.R. et al. (1991). Recent Clinical Results in the Chemotherapy of Brain Tumors: BTCG Studies. In: Paoletti, P., Takakura, K., Walker, M.D., Butti, G., Pezzotta, S. (eds) Neuro-Oncology. Developments in Oncology, vol 66. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-3152-0_25
Download citation
DOI: https://doi.org/10.1007/978-94-011-3152-0_25
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-5390-7
Online ISBN: 978-94-011-3152-0
eBook Packages: Springer Book Archive