Читать книгу Intracranial Gliomas Part II - Adjuvant Therapy - Группа авторов - Страница 50

Glioblastoma multiforme (GBM) is the most common primary brain tumor corresponding to World Health Organization (WHO) histopathological grade IV. In the 1960s and 1970s, the Brain Tumor Study Group (BTSG) performed several randomized controlled trials to evaluate the role of FRT in the management of GBM. The BTSG 6901 study randomized patients with surgically treated high-grade gliomas (HGG) to receive best supportive care, BCNU chemotherapy, radiation, or BCNU with radiation [2]. Those receiving FRT had a median survival of 35 weeks compared with 14 weeks for best supportive care and 18.5 weeks for BCNU alone. The BTSG 7201 study randomized patients with HGG who underwent definitive surgery to receive either semustine (methyl-CCNU) alone, radiation alone, semustine with radiation, or BCNU with radiation [3]. Once again, the radiation-containing arms demonstrated improved survival over chemotherapy alone. Based on these level 1 data, surgery followed by FRT emerged as the standard of care in the management of HGG. This remained until 2005, when Stupp et al. [4] published the results of a randomized controlled trial showing a survival benefit with the addition of temozolomide (TMZ) during and following FRT in patients with GBM.