Benefits of adjuvant chemotherapy in high-grade gliomas Journal Article
| Author: | Deangelis, L. M. |
| Article Title: | Benefits of adjuvant chemotherapy in high-grade gliomas |
| Abstract: | The current standard of care for patients with high-grade glioma is resection followed by radiotherapy. Adjuvant chemotherapy is not widely accepted because of the low sensitivity of gliomas to traditional antineoplastic agents, the poor penetration of most drugs across the blood-brain barrier, and the significant systemic toxicity associated with current agents. However, nitrosoureas and, subsequently, temozolomide (Temodar [US], Temodal [international]; Schering-Plough Corporation, Kenilworth, NJ), a novel alkylating agent, cross the blood-brain barrier and have activity against gliomas. Nitrosoureas have been studied in phase III trials in the adjuvant setting. In individual trials, chemotherapy did not increase median survival but did increase the proportion of patients surviving ≥18 months by 15%. Only with large meta-analyses did the addition of chemotherapy achieve a statistically significant improvement in median survival. Currently there is no means of identifying which patients will benefit from adjuvant chemotherapy, but nitrosoureas and temozolomide are well tolerated in most patients, justifying the administration of adjuvant chemotherapy to all newly diagnosed patients with malignant glioma. © 2003 Elsevier Inc. All rights reserved. |
| Keywords: | cancer survival; cancer surgery; survival rate; clinical trial; drug tolerability; mortality; drug efficacy; drug penetration; patient selection; conference paper; cancer adjuvant therapy; cancer radiotherapy; chemotherapy, adjuvant; temozolomide; brain tumor; glioma; brain neoplasms; antineoplastic agent; treatment indication; dacarbazine; alkylating agent; antineoplastic activity; drug effect; carmustine; lomustine; standard; survival time; adjuvant chemotherapy; blood brain barrier; antineoplastic agents, alkylating; drug derivative; drug toxicity; phase 3 clinical trial; drug sensitivity; drug indication; nitrosourea derivative; mitolactol; humans; human; priority journal; nitrosourea compounds |
| Journal Title: | Seminars in Oncology |
| Volume: | 30 |
| Issue: | 6 Suppl.19 |
| ISSN: | 0093-7754 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2003-12-01 |
| Start Page: | 15 |
| End Page: | 18 |
| Language: | English |
| PUBMED: | 14765379 |
| PROVIDER: | scopus |
| DOI: | 10.1053/j.seminoncol.2003.11.037 |
| DOI/URL: | |
| Notes: | Presented at the 2nd International Conference on the Treatment of Brain Tumors; 2003 Mar 14-15; Padua, Italy -- Export Date: 25 September 2014 -- Source: Scopus |
