High Dose BCNU Chemotherapy for Grade IV Astrocytoma
Author Information
Author(s): E.K. Mbiddel, P.J. Selby, T.J. Perren, D.P. Dearnaley, A. Whitton, S. Ashley, P. Workman, H.J.G. Bloom, T.J. McElwain
Primary Institution: Royal Marsden Hospital
Hypothesis
The high dose of BCNU when given to tumours before irradiation might be expected to result in improved penetration into the tumour and an enhanced anti-tumour effect.
Conclusion
High dose BCNU chemotherapy followed by radiotherapy may slightly prolong survival in patients with grade IV astrocytoma, but it is not routinely recommended due to significant toxicity.
Supporting Evidence
- Five of the 22 patients remain alive at the time of writing.
- The median survival time is 17 months.
- Thirteen of 20 patients had grade I WHO toxicity.
- Late marrow failure occurred in 4 patients, contributing to 2 deaths.
Takeaway
Doctors tried a strong medicine to help people with a serious brain tumor, but it didn't help enough and caused some bad side effects.
Methodology
Patients received high dose BCNU followed by autologous bone marrow transplantation and full dose radiotherapy, with evaluations of toxicity and survival.
Potential Biases
The study was conducted at a single institution, which may introduce bias in patient selection and care.
Limitations
The study had a small sample size and was not randomized, limiting the generalizability of the results.
Participant Demographics
22 patients aged less than 60 years, with a median age of 47 years, including 12 males and 10 females.
Statistical Information
Statistical Significance
p<0.05
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