Treatment of grade III and IV astrocytoma with high-dose irradiation: schedule and chemotherapy.

From October 1978 to June 1981, 35 consecutive patients with grade III-IV malignant glioma were treated with a concentrated course of radiotherapy (two cycles of 17 Gy in two sessions over a 3-day period) with a cobalt unit, followed by chemotherapy with vincristine and BCNU. In the 30 evaluable patients, no complete remission, seven partial remissions, 23 stable disease, and no progression were encountered. Median duration of response was 6 months (range 4-11+). Median survival time was 9 months (range 7-19); radically resected patients survived longer than those with inoperable tumor. Toxicity of treatment was acceptable; however, two patients with brain stem tumors had acute neurologic toxicity following the first radiotherapy session.