Chemotherapy Following Radiation Improves Outcomes in Low Grade Glioblastoma
According to results recently presented at the 2014 annual meeting of the American Society of Clinical Onoclogy, patients with low-grade glioblastom multiforme (GBM) benefited from chemotherapy following radiation therapy compared to radiation therapy alone.
consisting of procarbazine, CCNU, and vincristine (PCV) administered following radiation therapy improved progression-free survival and overall survival in adults with low-grade glioblastoma multiforme (GBM), a form of brain cancer, when compared to radiation therapy alone.
Approximately 23,000 people will be diagnosed with primary brain tumors in the United States in 2014 and, of those, 10 to 15 percent will have low-grade GBM. Glioblastoma multiforme is an aggressive type of type of brain tumor that occurs mainly in adults. Treatment often involves surgery followed by radiation and chemotherapy. With standard care, the median length of survival is 15 months after diagnosis and only 10 percent of patients survive more than five years. Because survival tends to be poor even with aggressive treatment, researchers continue to evaluate new ways of treating this disease.
The trial, RTOG 9802, enrolled 251 patients with low-grade GBM who were considered at high risk compared to other low-grade GBM patients because they were 40 years of age or older or had a less than complete surgical removal of their tumor if they were under 40. Chemotherapy included procarbazine, CCNU, and vincristine (PCV). Researchers reported that chemotherapy following radiation therapy improved progression-free survival and overall survival. One of the lead investigators in the study, Jan C. Buckner, MD from the Mayo clinic indicated that “On average, patients who received PCV lived 5.5 years longer than those who received radiation alone.” “These findings build on results published in the Journal of Clinical Oncology in 2012 which showed that PCV given with radiation therapy at the time of initial diagnosis prolongs progression free-survival but not overall survival.”
Investigators also found that patients with oligodendroglioma had better outcomes than those with astrocytoma or oligoastrocytoma, as did females.
Reference: Buckner J, Pugh S, Shaw E, et al. Phase III study of radiation therapy (RT) with or without procarbazine, CCNU, and vincristine (PCV) in low-grade glioma: RTOG 9802 with Alliance, ECOG, and SWOG. J Clin Oncol 32:5s, 2014 (suppl; abstr 2000).