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dc.contributor.authorThomas, Den_US
dc.contributor.authorBrada, Men_US
dc.contributor.authorStenning, Sen_US
dc.contributor.authorWork, MRCBTen_US
dc.identifier.citationJOURNAL OF CLINICAL ONCOLOGY, 2001, 19 pp. 509 - 518en_US
dc.description.abstractPurpose: Meta-analyses of the published literature suggest ct survival benefit to adjuvant chemotherapy for high-grade astrocytoma, which individual sma trials have been unable to demonstrate reliably. The Medical Research Council Brain Tumour Working Party initiated the largest randomized trial of adjuvant chemotherapy for glioma in an attempt to provide a definitive answer. Patients and Methods: After surgery, patients aged less than or equal to 70 years, with World Health Organization grade 3 or 4 astrocytoma, were randomized to radiotherapy alone (RT) or RT plus procarbazine, lomustine, and vincristine (PCV) chemotherapy (RT-PCV) given at 6-week intervals to a maximum of 12 courses (procarbazine 100 mg/m(2) days 1 to 10, lomustine 100 mg/m(2) day 1,and vincristine 1.5 mg/m(2) (max 2 mg) day 1). A neuropathology panel independently reviewed all cases. To reliably detect a 10% increase in 2-year survival (from 15% to 25%), 600 patients were required. Results: Between September 1988 and May 1997, 15 United Kingdom centers randomized 674 patients (RT = 339 patients; RT-PCV = 335 patients). With a median follow-up for survivors of 3 years, 617 patients have died, (RT = 310 patients; RT-PCV = 307 patients). Median survival was 9.5 months for RT and 10 months for RT-PCV (hazard ratio = 0.95; 95% confidence interval, 0.81 to 1.11; log-rank P =.50). Tests for interaction revealed no significant differences in treatment effect according to tumor grade, age, performance status, or extent of neurosurgery. Conclusion: This trial shows no benefit to PCV chemotherapy, and current data exclude an increase in median survival of more than 10 weeks and in a 1- or 2-year survival rate of more than 7% to 8%. This suggests that no-chemotherapy control arms remain ethical in randomized trials in high-grade astrocytoma. J Clin Oncol 19:509-518, (C) 2001 by American Society of Clinical Oncology.en_US
dc.format.extent509 - 518en_US
dc.titleRandomized trial of porcarbazine, lomustine, and vincristine in the adjuvant treatment of high-grade astrocytoma: A medical research council trialen_US
dc.typeJournal Article
rioxxterms.typeJournal Article/Reviewen_US
pubs.notesorcid-numbers: Gaze, Mark/0000-0002-8344-7902 unique-id: ISI:000166534000030en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Brada)
pubs.embargo.termsNot knownen_US
icr.researchteamClinical Academic Radiotherapy (Brada)en_US
dc.contributor.icrauthorBrada, Michaelen_US

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