Randomized comparison of stereotactic radiosurgery followed by conventional radiotherapy with carmustine to conventional radiotherapy with carmustine for patients with glioblastoma multiforme: Report of Radiation Therapy Oncology Group 93-05 protocol
Randomized comparison of stereotactic radiosurgery followed by conventional radiotherapy with carmustine to conventional radiotherapy with carmustine for patients with glioblastoma multiforme: Report of Radiation Therapy Oncology Group 93-05 protocol
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DOI：
10.1016/j.ijrobp.2004.04.011
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发表时间：
2004-11-01
影响因子：
7
通讯作者：
Curran, WJ
中科院分区：
文献类型：
--
作者：
Souhami, L;Seiferheld, W;Curran, WJ
目的：多形性胶质母细胞瘤（GBM）的常规治疗治愈率不到5%。我们研究了立体定向放射外科（SRS）加用卡莫司汀（BCNU）的常规外照射放射治疗（EBRT）对GBM患者生存率的影响。方法和材料：共203例幕上GBM患者，肿瘤小于或等于40 mm的患者随机分为两组，一组接受术后SRS，另一组接受EBRT（60戈伊）+BCNU（80 mg/m（2）第1-3天，每8周一次，共6个周期）或EBRT与BCNU单独。放射外科的剂量是肿瘤大小依赖性的，范围从最大的15戈伊到最小的24戈伊。RT和BCNU是相同的两arms.Results：在中位随访时间为61个月，中位生存在放射外科组为13.5个月（95%置信区间，11.0-14.8）相比，13.6个月（95%置信区间，11.2-15.2，p = 0.5711）的标准治疗组。两组之间的2年和3年生存率以及失败模式也没有显著差异。生活质量恶化和认知能力下降，在治疗结束时，与基线相比，是可比的，有没有差异，在质量调整后的生存arms.Conclusions：立体定向放射外科手术后EBRT和BCNU不改善GBM患者的结果，也不改变一般的生活质量或认知功能。(C)2004年爱思唯尔公司
Purpose: Conventional treatment of glioblastoma multiforme (GBM) cures less than 5% of patients. We investigated the effect of stereotactic radiosurgery (SRS) added to conventional external beam radiation therapy (EBRT) with carmustine (BCNU) on the survival of patients with GBM.Methods and Materials: A total of 203 patients with supratentorial GBM (tumor less than or equal to40 mm) were randomly assigned either to postoperative SRS followed by EBRT (60 Gy) plus BCNU (80 mg/m(2) Days 1-3 every 8 weeks for six cycles) or to EBRT with BCNU alone. The dose of radiosurgery was tumor size-dependent and ranged from 15 Gy for largest to 24 Gy for smallest tumors. RT and BCNU were identical in both arms.Results: At a median follow-up time of 61 months, the median survival in the radiosurgery group was 13.5 months (95% confidence interval, 11.0-14.8) as compared with 13.6 months (95% confidence interval, 11.2-15.2, p = 0.5711) for the standard treatment group. There were also no significant differences in 2- and 3-year survival rates and in patterns of failure between the two arms. Quality of life deterioration and cognitive decline at the end of therapy, compared with baseline, were comparable and there was no difference in quality-adjusted survival between the arms.Conclusions: Stereotactic radiosurgery followed by EBRT and BCNU does not improve the outcome in patients with GBM nor does it change the general quality of life or cognitive functioning. (C) 2004 Elsevier Inc.