J Korean Neurosurg Soc.  2012 Apr;51(4):199-202. 10.3340/jkns.2012.51.4.199.

The Role of Chemotherapy in Anaplastic Astrocytoma Patients

• Kim SK
• Kim JW
• Kim YH
• Kim TM
• Lee SH
• Park CK

• KMID: 2066910
• DOI: http://doi.org/10.3340/jkns.2012.51.4.199

Abstract

OBJECTIVE
This retrospective study was performed to evaluate the role of chemotherapy in the management of patients with anaplastic astrocytoma (AA).
METHODS
We compared the survival outcome among the 3 different treatment protocol groups in a single institution. A total of 86 patients (39 men and 47 women) with newly diagnosed AA after surgery were analyzed. Among them, 31 patients (36.0%) were treated with radiotherapy only (RT Group), 30 patients (34.9%) were treated with nimustine-cisplatin chemotherapy before RT (ACNU-CDDP group), and 25 patients (29.1%) were treated with procarbazine, lomustine and vincristine (PCV) chemotherapy after radiotherapy (PCV group).
RESULTS
The median survival was 14.0, 30.0 and 72.0 months in RT, ACNU-CDDP, and PCV group, respectively and showed significant differences (RT vs. ACNU-CDDP; p=0.039, RT vs. PCV; 0.002, ACNU-CDDP vs. PCV; 0.045). PCV group showed less toxicity rate (5 patients; 20%) than ACNU-CDDP group (12 patients; 40%), while only 3 patients (9.6%) in RT group experienced grade 3 or 4 toxicities.
CONCLUSION
An application of chemotherapy before or after radiotherapy is beneficial in prolonging the survival of patients with AA. Adjuvant PCV chemotherapy after radiotherapy is recommendable.

Keyword

Anaplastic astrocytoma; Chemotherapy; Procarbazine; Lomustine; Vincristine; PCV; Nimustine-cisplatin

MeSH Terms

Astrocytoma
Clinical Protocols
Humans
Lomustine
Male
Procarbazine
Retrospective Studies
Vincristine
Lomustine
Procarbazine
Vincristine

Figure

• 

  Fig. 1 Kaplan-Meier estimates of overall survival according to treatment group. Significant differences in estimated survival among treatment groups were observed (p=0.002 between PCV group and RT group; p=0.045 between PCV group and ACNU-CDDP group; p=0.039 between ACNU-CDDP group and RT group). PCV : procarbazine, lomustine and vincristine, ACNU-CDDP : nimustine-cisplatin, RT : radiotherapy.

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