Adjuvant chemotherapy with VM 26 and CCNU after operation and radiotherapy of high-grade supratentorial astrocytomas.

Thirty-one patients with histologically proven malignant (Grade III and IV) astrocytomas were randomly placed in one of two treatment schedules two weeks after gross total or subtotal tumor removal. One group (15 patients) received radiation therapy and adjuvant chemotherapy with VM 26 and CCNU once every four weeks, commencing four weeks after the completion of radiotherapy. The second group (16 patients) received radiotherapy alone. The duration of the progression-free interval from operation to recurrence was measured to evaluate the effect of the adjuvant chemotherapy. The median free interval calculated by the computer analysis according to the method of Kaplan and Meier was 65.5 weeks for the chemotherapy group and 40.0 weeks for the control group. The difference is not statistically significant. From our experience, adjuvant chemotherapy should only be given to patients with residual or progressive tumors following radiation therapy.