The combination of chemotherapy and radiation therapy may improve progression-free survival (PFS) and overall survival in patients with grade 2 glioma, according to a recent study.
Glioma is a form of brain cancer that occurs most commonly in young adults and is associated with significant neurologic deterioration and premature death. With brain tumors, oncologists face the challenge of managing the disease while minimizing toxicities related to treatment.
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In a study published in the New England Journal of Medicine, investigators led by Jan C Buckner, MD, Mayo Clinic (Rochester, MN), reported the long-term results of a clinical trial evaluating the outcomes of treatment with procarbazine, lomustine, and vincristine after radiation therapy at the time of initial diagnosis of glioma. Initial results reported by the investigators had shown that treatment with the chemotherapy agents after radiation lengthened PFS for patients but produced no significant change in overall survival.
A total of 251 patients were enrolled in the trial from 1998 through 2002. All participants were between the ages of 18 and 39 years of age or were older than 40 years of age and had undergone biopsy or resection to remove a tumor. The median follow-up period was 11.9 months; at the time of analysis, more than half (55%) of patients had died.
Investigators observed that patients who received radiation plus chemotherapy had longer PFS than those who were treated with radiation therapy alone (13.3 years vs 7.8 years), which was consistent with earlier reported data.
At 10 years, the rate of progression free survival was 51% in the group with chemotherapy added compared with just 21% in the group who received radiation therapy alone. Unlike initial results of the trial, at 10 years, the rate of overall survival was significantly improved in patients who were treated with both chemotherapy and radiation compared with just radiation (60% vs 40%).
Further statistical analysis of the data verified the results, leading investigators to conclude that chemotherapy plus radiation led to improved long-term outcomes in this patient population.
