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Titolo:
Randomized trial of porcarbazine, lomustine, and vincristine in the adjuvant treatment of high-grade astrocytoma: A medical research council trial
Autore:
Thomas, D; Brada, M; Stenning, S;
Indirizzi:
MRC, Clin Trials Unit, Canc Div, London NW1 2DA, England MRC London England NW1 2DA rials Unit, Canc Div, London NW1 2DA, England
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 2, volume: 19, anno: 2001,
pagine: 509 - 518
SICI:
0732-183X(20010115)19:2<509:RTOPLA>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
MALIGNANT BRAIN-TUMORS; RADIATION-THERAPY; POSTOPERATIVE RADIOTHERAPY; COMBINATION CHEMOTHERAPY; ANAPLASTIC GLIOMAS; CCNU; PROCARBAZINE; BCNU; DIBROMODULCITOL; NITROSOUREAS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Thomas, D MRC, Clin Trials Unit, Canc Div, MRC BR05 Trial,222 Euston Rd, London NW1 2DA, England MRC MRC BR05 Trial,222 Euston Rd London England NW12DA England
Citazione:
D. Thomas et al., "Randomized trial of porcarbazine, lomustine, and vincristine in the adjuvant treatment of high-grade astrocytoma: A medical research council trial", J CL ONCOL, 19(2), 2001, pp. 509-518

Abstract

Purpose: Meta-analyses of the published literature suggest ct survival benefit to adjuvant chemotherapy for high-grade astrocytoma, which individual sma trials have been unable to demonstrate reliably. The Medical Research Council Brain Tumour Working Party initiated the largest randomized trial ofadjuvant chemotherapy for glioma in an attempt to provide a definitive answer. Patients and Methods: After surgery, patients aged less than or equal to 70 years, with World Health Organization grade 3 or 4 astrocytoma, were randomized to radiotherapy alone (RT) or RT plus procarbazine, lomustine, and vincristine (PCV) chemotherapy (RT-PCV) given at 6-week intervals to a maximum of 12 courses (procarbazine 100 mg/m(2) days 1 to 10, lomustine 100 mg/m(2) day 1,and vincristine 1.5 mg/m(2) (max 2 mg) day 1). A neuropathology panel independently reviewed all cases. To reliably detect a 10% increase in2-year survival (from 15% to 25%), 600 patients were required. Results: Between September 1988 and May 1997, 15 United Kingdom centers randomized 674 patients (RT = 339 patients; RT-PCV = 335 patients). With a median follow-up for survivors of 3 years, 617 patients have died, (RT = 310 patients; RT-PCV = 307 patients). Median survival was 9.5 months for RT and10 months for RT-PCV (hazard ratio = 0.95; 95% confidence interval, 0.81 to 1.11; log-rank P =.50). Tests for interaction revealed no significant differences in treatment effect according to tumor grade, age, performance status, or extent of neurosurgery. Conclusion: This trial shows no benefit to PCV chemotherapy, and current data exclude an increase in median survival of more than 10 weeks and in a 1- or 2-year survival rate of more than 7% to 8%. This suggests that no-chemotherapy control arms remain ethical in randomized trials in high-grade astrocytoma. J Clin Oncol 19:509-518, (C) 2001 by American Society of ClinicalOncology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 10:20:09