An Analysis of Combined interferon-beta, BCNU and Radiation in the Treatment of Malignant Glioma

ABSTRACT

Prognosis for patients with a malignant glioma of the brain is, up to the present time, very poor. Surgery is unlikely to be curative and the primary goals of the surgery are(1) to make a histologic diagnosis, (2) to determine the extent of the lesion and (3) if possible, to debulk the tumor. The inclusion of radiation therapy following surgery prolonged median survival time by about 0 weeks as compared to surgery alone or surgery with chemotherapy. 50 patients with anaplastic astrocytoma or glioblastoma multiforme were treated at the Department of Neurosurgery. C.U.M.C. Mar. 1991 and Jul. 1994. All patients were treated with surgical resection, irradiation, chemotherapy with BCNU(1, 3bis(2chloroentlyl) 1nitrosourea), and immunotherapy with interferon beta(IBR therapy). Interferon beta was given in dosages of 100,000~300,000 U for 7 days and BCNU was given in doses of 200mg/sqm for 1 day, intravenously before postoperative radiotherapy and was repeated at the interval of 6 weeks. Survival rates were analyzed between our IBR therapy group and historical data of radiation therapy alone. Several prognostic factors were analyzed in the IBR therapy group. Survival curves were observed according to the Kaplan Meier method. Our observation revealed that IBR therapy showed encouraging results in some patients without stastistical significant in general. However, despite the above observtion, we believe that the statistical out come of the IBR group may change statistically if given a longer follow up period. Furthrmore, our study also demonstrated that the improved survival time gained from total resection over subtotal resection was statistically significant.