Effect of Postoperative Radiotherapy Concurrent Chemotherapy on Adult Patients with Grade Ⅱ～ ⅣCerebral Gliomas

Objective 　To prospectively study the survival of adult patients with grade Ⅱ～ Ⅳcerebral gliomas received radiochemotherapy postoperatively. Methods 　From sept . 1999 to may 2003, 80 adult postoperative patients with grade Ⅱ～ Ⅳcerebral gliomass were treated and divided into two groups randomly, each had 40 cases. One group (RT group) was irradiated with DT50～60 Gy merely and the other (RCT group) combined with chemotherapy(VM-26 and Me-CCNU) after DT20 Gy and 4～6 cycles of chemotherapy were delivered within 4～6 months. Results 　The 1-, 3-, and 5- year survival rate of patients of RCT group was 85. 00 %、52. 50 %、30. 00 % while the survival rate of RT group was 62. 50 %、27. 50 %、15. 00 %, respectively. The difference of the survival rates between two groups was significant (χ² = 5. 07, P = 0. 024) . Based on pathological grades, however, it was suggested that only the patients with grade Ⅲgliomas of RCT group had better prognosis than ones of RT group (χ² = 3. 96, P = 0. 047) . The similar results were not found in patients with grade Ⅱor Ⅳgliomas. Conclusion 　Given concurrent radiochemotherapy postoperatively, the survival could be improved in adult patients with grade Ⅲgliomas. And the data suggested that VM-26 combined with Me-CCNU should be an effective chemotherapeutic scheme. AS to grade Ⅳgliomas, more novel chemotherapeutic methods shoud be studied. The patients with grade Ⅱgliomas needn't receive chemotherapy besides postoperative radiotherapy.