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Addition of Chemotherapy Dramatically Improves Survival in Low-Grade Gliomas

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The addition of chemotherapy to radiation therapy significantly improves survival among patients with low-grade glioma. These results were recently presented at the 2014 annual meeting of the American Society of Clinical Oncology (ASCO).

Gliomas are a type of brain tumor that are considered cancerous. Gliomas are graded based upon their aggressiveness and invasiveness, with a higher grade representing a more advanced glioma.

Although treatment for gliomas at present often involves combination therapy including chemotherapy and radiation therapy, there has not yet been a large, phase III randomized clinical trial directly comparing radiation therapy to chemotherapy plus radiation therapy that has demonstrated a dramatic survival improvement.

Researchers from several medical organizations conducted a clinical trial to directly compare chemotherapy plus radiation to radiation therapy only among patients with grade II gliomas. From this trial, results were obtained in 2012 that demonstrated a progression-free survival, but not overall survival with the addition of chemotherapy. Now, researchers from the study have obtained updated results to determine if the longer follow-up demonstrated a survival difference between the two types of treatment. Median follow-up is now nearly 12 years.

Overall survival was 13.3 years for patients treated with chemotherapy plus radiation, compared with only 7.8 years for those treated with radiation only.
Patients with astrocytoma as well as males demonstrated an overall worse survival than the rest of the patients.
Analyses that more fully evaluate mutational details are planned in an attempt to identify patients who gain the most benefit from treatment.
The chemotherapy combination used in this trial is referred to as PCV; however, newer chemotherapy regimens have been approved for the treatment of gliomas. Therefore, the newer chemotherapy regimens may demonstrate even greater survival improvements, but long-term results from trials must be awaited prior to this determination.
Reference: Buckner J, Pugh S, Shaw E, et al. Phase III study of radiation therapy (RT) with or without procarbazine, CCNU, and vincristine (PCV) in low-grade glioma: RTOG 9802 with Alliance, ECOG, and SWOG. Proceedings from the 2014 annual meeting of the American Society of Clinical Oncology. Abstract 2000. Available at:http://abstracts.asco.org/144/AbstView_144_127483.html. Accessed June 11, 2014.