Randomized comparison of stereotactic radiosurgery followed by conventional radiotherapy with carmustine to conventional radiotherapy with carmustine for patients with glioblastoma multiforme: Report of Radiation Therapy Oncology Group 93-05 protocol

Luis Souhami, Wendy Seiferheld, David Brachman, Ervin B. Podgorsak, Maria Werner-Wasik, Robert Lustig, Christopher J. Schultz, William Sause, Paul Okunieff, Jan Craig Buckner, Lucia Zamorano, Minesh P. Mehta, Walter J. Curran

Research output: Contribution to journalArticle

362 Citations (Scopus)

Abstract

Purpose Conventional treatment of glioblastoma multiforme (GBM) cures less than 5% of patients. We investigated the effect of stereotactic radiosurgery (SRS) added to conventional external beam radiation therapy (EBRT) with carmustine (BCNU) on the survival of patients with GBM. Methods and materials A total of 203 patients with supratentorial GBM (tumor ≤40 mm) were randomly assigned either to postoperative SRS followed by EBRT (60 Gy) plus BCNU (80 mg/m2 Days 1-3 every 8 weeks for six cycles) or to EBRT with BCNU alone. The dose of radiosurgery was tumor size-dependent and ranged from 15 Gy for largest to 24 Gy for smallest tumors. RT and BCNU were identical in both arms. Results At a median follow-up time of 61 months, the median survival in the radiosurgery group was 13.5 months (95% confidence interval, 11.0-14.8) as compared with 13.6 months (95% confidence interval, 11.2-15.2, p = 0.5711) for the standard treatment group. There were also no significant differences in 2- and 3-year survival rates and in patterns of failure between the two arms. Quality of life deterioration and cognitive decline at the end of therapy, compared with baseline, were comparable and there was no difference in quality-adjusted survival between the arms. Conclusions Stereotactic radiosurgery followed by EBRT and BCNU does not improve the outcome in patients with GBM nor does it change the general quality of life or cognitive functioning.

Original languageEnglish (US)
Pages (from-to)853-860
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume60
Issue number3
DOIs
StatePublished - Nov 1 2004

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Carmustine
Radiation Oncology
Radiosurgery
Glioblastoma
radiation therapy
Radiotherapy
tumors
confidence
intervals
Survival
deterioration
Quality of Life
Confidence Intervals
therapy
Neoplasms
dosage
cycles
Therapeutics
Survival Rate

Keywords

  • Glioblastoma multiforme
  • Quality of life
  • Radiation therapy
  • Stereotactic radiosurgery

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Randomized comparison of stereotactic radiosurgery followed by conventional radiotherapy with carmustine to conventional radiotherapy with carmustine for patients with glioblastoma multiforme : Report of Radiation Therapy Oncology Group 93-05 protocol. / Souhami, Luis; Seiferheld, Wendy; Brachman, David; Podgorsak, Ervin B.; Werner-Wasik, Maria; Lustig, Robert; Schultz, Christopher J.; Sause, William; Okunieff, Paul; Buckner, Jan Craig; Zamorano, Lucia; Mehta, Minesh P.; Curran, Walter J.

In: International Journal of Radiation Oncology Biology Physics, Vol. 60, No. 3, 01.11.2004, p. 853-860.

Research output: Contribution to journalArticle

Souhami, Luis ; Seiferheld, Wendy ; Brachman, David ; Podgorsak, Ervin B. ; Werner-Wasik, Maria ; Lustig, Robert ; Schultz, Christopher J. ; Sause, William ; Okunieff, Paul ; Buckner, Jan Craig ; Zamorano, Lucia ; Mehta, Minesh P. ; Curran, Walter J. / Randomized comparison of stereotactic radiosurgery followed by conventional radiotherapy with carmustine to conventional radiotherapy with carmustine for patients with glioblastoma multiforme : Report of Radiation Therapy Oncology Group 93-05 protocol. In: International Journal of Radiation Oncology Biology Physics. 2004 ; Vol. 60, No. 3. pp. 853-860.
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abstract = "Purpose Conventional treatment of glioblastoma multiforme (GBM) cures less than 5{\%} of patients. We investigated the effect of stereotactic radiosurgery (SRS) added to conventional external beam radiation therapy (EBRT) with carmustine (BCNU) on the survival of patients with GBM. Methods and materials A total of 203 patients with supratentorial GBM (tumor ≤40 mm) were randomly assigned either to postoperative SRS followed by EBRT (60 Gy) plus BCNU (80 mg/m2 Days 1-3 every 8 weeks for six cycles) or to EBRT with BCNU alone. The dose of radiosurgery was tumor size-dependent and ranged from 15 Gy for largest to 24 Gy for smallest tumors. RT and BCNU were identical in both arms. Results At a median follow-up time of 61 months, the median survival in the radiosurgery group was 13.5 months (95{\%} confidence interval, 11.0-14.8) as compared with 13.6 months (95{\%} confidence interval, 11.2-15.2, p = 0.5711) for the standard treatment group. There were also no significant differences in 2- and 3-year survival rates and in patterns of failure between the two arms. Quality of life deterioration and cognitive decline at the end of therapy, compared with baseline, were comparable and there was no difference in quality-adjusted survival between the arms. Conclusions Stereotactic radiosurgery followed by EBRT and BCNU does not improve the outcome in patients with GBM nor does it change the general quality of life or cognitive functioning.",
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AU - Souhami, Luis

AU - Seiferheld, Wendy

AU - Brachman, David

AU - Podgorsak, Ervin B.

AU - Werner-Wasik, Maria

AU - Lustig, Robert

AU - Schultz, Christopher J.

AU - Sause, William

AU - Okunieff, Paul

AU - Buckner, Jan Craig

AU - Zamorano, Lucia

AU - Mehta, Minesh P.

AU - Curran, Walter J.

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N2 - Purpose Conventional treatment of glioblastoma multiforme (GBM) cures less than 5% of patients. We investigated the effect of stereotactic radiosurgery (SRS) added to conventional external beam radiation therapy (EBRT) with carmustine (BCNU) on the survival of patients with GBM. Methods and materials A total of 203 patients with supratentorial GBM (tumor ≤40 mm) were randomly assigned either to postoperative SRS followed by EBRT (60 Gy) plus BCNU (80 mg/m2 Days 1-3 every 8 weeks for six cycles) or to EBRT with BCNU alone. The dose of radiosurgery was tumor size-dependent and ranged from 15 Gy for largest to 24 Gy for smallest tumors. RT and BCNU were identical in both arms. Results At a median follow-up time of 61 months, the median survival in the radiosurgery group was 13.5 months (95% confidence interval, 11.0-14.8) as compared with 13.6 months (95% confidence interval, 11.2-15.2, p = 0.5711) for the standard treatment group. There were also no significant differences in 2- and 3-year survival rates and in patterns of failure between the two arms. Quality of life deterioration and cognitive decline at the end of therapy, compared with baseline, were comparable and there was no difference in quality-adjusted survival between the arms. Conclusions Stereotactic radiosurgery followed by EBRT and BCNU does not improve the outcome in patients with GBM nor does it change the general quality of life or cognitive functioning.

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KW - Quality of life

KW - Radiation therapy

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