Medical Oncology

, Volume 14, Issue 2, pp 103–120

Current perspectives in gliomas

  • C. S. Brock
  • M. Bower


The annual incidence of primary central nervous system tumors, including gliomas, is increasing, however, the prognosis of these tumors remains poor with a median survival of only 5 years. The imaging of tumors by computerised tomography, magnetic resonance imaging and newer methods such as positron emission tomography and proton magnetic resonance spectroscopy (1H-MRS) is increasing our knowledge of tumor biology and extent of the disease. Advances within the field of neurosurgery have improved operative procedures reducing mortality and morbidity. Furthermore, radiotherapy planning, tumor targeting and repositioning for treatment have all improved initial tumor management The role of adjuvant chemotherapy remains controversial. Chemotherapy for advanced and recurrent disease has been extensively investigated, and although improvements in quality of life have been recorded, no prolongation of survival has been documented. With new discoveries and increasing knowledge of the physiology and molecular biology of these tumors the potential for targeting therapy at a genetic level is becoming increasingly promising. This review provides an overview of these current perspectives in glioma management.


glioma astrocytoma chemotherapy imaging molecular biology radiotherapy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Greig, N.H., Ries, LG., Yancik, R. and Rapoport, S.I. (1990) Increasing annual incidence of primary malignant brain tumors in the elderly [see comments].J. Natl. Cancer Inst. 82(20), 1621–4.PubMedCrossRefGoogle Scholar
  2. 2.
    OPCS. Cancer Statistics — Registrations (1988). Series MB1 1993; no. 21(HMSO).Google Scholar
  3. 3.
    Burger, P.C., Scheithauer, B.W. and Vogel, F.S. (1991)Surgical Pathology of the Nervous System and its Coverings. 3rd edn. New York: Churchill Livingstone.Google Scholar
  4. 4.
    Svien, HJ., Mabon, R.F., Kernohan, J.W., and Adson, A.W. (1949) Astrocytomas.Proc. Staff. Meet. Mayo. Clin. 24, 54–64.Google Scholar
  5. 5.
    Kernohan, J.W., Mabon, R.F., Svien, H.J., and Adson, A.W. (1949) A simplified classification of gliomas.Proc. Staff Meet. Mayo Clin. 24, 71–5.Google Scholar
  6. 6.
    Ringertz, N. (1950) Grading of gliomas.Ada Pathol. Microbiol. Scand. 27, 51–64.Google Scholar
  7. 7.
    Nelson, J.S., Tsukada, Y., Schoenfeld, D., Fulling, K., Lamarche, J. and Peress, N. (1983) Necrosis as a prognostic criterion in malignant supratentorial, astrocytic gliomas.Cancer 52(3), 550–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Daumas Duport, C., Scheithauer, B., O’Fallon, J. and Kelly, P. (1988) Grading of astrocytomas. A simple and reproducible method.Cancer 62(10), 2152–65.PubMedCrossRefGoogle Scholar
  9. 9.
    Kim, T.S., Halliday, A.L., Hedley Whyte, E.T. and Convery, K. (1991) Correlates of survival and the Daumas-Duport grading system for astrocytomas.J. Neurosurg. 74(1), 27–37.PubMedGoogle Scholar
  10. 10.
    Kleihues, P., Burger, P.C. and Scheithauer, B.W. (1993) The new WHO classification of brain tumours.Brain Pathol. 3(3), 255–68.PubMedCrossRefGoogle Scholar
  11. 11.
    Bruner, J.M. (1994) Neuropathology of Malignant Gliomas. (1994)Semin. Oncol. 21, 126–38.PubMedGoogle Scholar
  12. 12.
    Krouwer, H.G., Davis, R.L., Silver, P. and Prados, M. (1991) Gemistocytic astrocytomas: a reappraisal.J. Neurosurg. 74(3), 399–406.PubMedGoogle Scholar
  13. 13.
    Libermann, T.A., Nusbaum, H.R., Razon, N., Kris, R., Lax, I., Soreq, H., Whittle, N., Waterfield, MD., Ullrich, A. and Schlessinger, J. (1985) Amplification, enhanced expression and possible rearrangement of EGF receptor gene in primary human brain rumours of glial origin.Nature 313(5998), 144–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Wong, A.J., Ruppert, J.M., Bigner, S.H., Grzeschik, C.H., Humphrey, P.A., Bigner, D.S. and Vogelstein, B. (1992) Structural alterations of the epidermal growth factor receptor gene in human gliomas.Proc. Natl. Acad. Sci. USA 89(7), 2965–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Collins, V.P. and James, C.D. (1993) Gene and chromosomal alterations associated with the development of human gliomas.FASEB J. 7(10), 926–30.PubMedGoogle Scholar
  16. 16.
    Ekstrand, A.J., James, C.D., Cavenee, W.K., Seliger, B., Pettersson, R.F. and Collins, V.P. (1991) Genes for epidermal growth, factor receptor, transforming growth factor alpha, and epidermal growth factor and their expression in human gliomasin vivo.Cancer Res. 51(8), 2164–72.PubMedGoogle Scholar
  17. 17.
    Wong, A.J., Zoltick, P.W. and Moscatello, D.K. (1994) The molecular biology and molecular genetics of astrocytic neoplasms.Semin. Oncol. 21(2), 139–48.PubMedGoogle Scholar
  18. 18.
    Takahashi, J.A., Fukumoto, M., Igarashi, K., Oda, Y., Kikuchi, H. and Hatanaka, M. (1992) Correlation of basic fibroblast growth factor expression levels with the degree of malignancy and vascularity in human gliomas.J. Neiirosurg. 76(5), 792–8.Google Scholar
  19. 19.
    Plate, K.H., Breier, G., Farrell, C.L. and Risau, W. (1992) Platelet-derived growth factor receptor-beta is induced during tumor development and upregulated during tumor progression in endothelial cells in human gliomas.Lab. Invest. 67(4), 529–34.PubMedGoogle Scholar
  20. 20.
    Engebraaten, O., Bjerkvig, R., Pedersen, P.H. and Laerum, O.D. (1993) Effects of EGF, bFGF, NGF and PDGF(bb) on cell proliferative, migratory and invasive capacities of human brain-tumour biopsiesin vitro.Int. J. Cancer 53(2), 209–14.PubMedCrossRefGoogle Scholar
  21. 21.
    Ueba, T., Nosaka, T., Takahashi, J.A., Shibata, F., Florkiewicz, R.Z., Vogelstein, B., Oda, Y., Kikuchi, H. and Hatanaka, M. (1994) Transcriptional regulation of basic fibroblast growth factor gene by p53 in human glioblastoma and hepatocellular carcinoma cells.Proc. Natl. Acad. Sci. USA 91(19), 9009–13.PubMedCrossRefGoogle Scholar
  22. 22.
    Bigner, S.H., Burger, P.C., Wong, A.J., Werner, M.H., Hamilton, SR., Muhlbaier, L.H., Vogelstein, B. and Bigner, D.D. (1988) Gene amplification in malignant human gliomas: clinical and histopathologic aspects.J. Neuropathol. Exp. Neurol. 47(3), 191–205.PubMedCrossRefGoogle Scholar
  23. 23.
    Li, F.P., Fraumeni, J.F., Mulvihill, J.J., Blather, W.A., Dreyfus, M.G., Tucker, MA. and Miller, R.M. (1988) A cancer family syndrome in twenty-four kindreds.Cancer Research 48, 5358–62.PubMedGoogle Scholar
  24. 24.
    Malkin, D., Li, F.P., Strong, L.C., Fraumeni, J.F. Jr, Nelson, C.E., Kim, D.H., Kassel, J., Gryka, M.A., Bischoff, F.Z., Tainsky, M.A. and Friend, S.H. (1990) Germ line p53 mutations in a familial syndrome of breast cancer, sarcomas, and other neoplasms [see comments].Science 250(4985), 1233–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Toguchida, J., Yamaguchi, T., Dayton, S.H., Beauchamp, R.L., Herrera, G.E., Ishizaki, K., Yamamuro, T., Meyers, P.A., Little, J.B., Sasaki, M.S., Weichselbaum, R.R. and Yandell, D.W. (1992) Prevalence and spectrum of germline mutations of the p53 gene among patients with sarcoma [see comments].N. Engl. J. Med. 326(20), 1301–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Levine, A.J., Perry, M.E., Chang, A., Silver, A., Dittmer, D., Wu, M. and Welsh, D. (1994) The 1993 Walter Hubert Lecture: the role of the p53 tumour-suppressor gene in tumorigenesis.Br. J. Cancer 69(3), 409–16.PubMedGoogle Scholar
  27. 27.
    Karamitopoulou, E., Perentes, E. and Diamantis, I. (1993) p53 protein expression in central nervous system tumors: an immunohistochemical study with CM1 polyvalent and DO-7 monoclonal antibodies.Acta Neuropathol. Berl. 85(6), 611–6.PubMedCrossRefGoogle Scholar
  28. 28.
    del Arco, A., Garcia, J., Arribas, C, Barrio, R., Blazquez, MG., Izquierdo, J.M. and Izquierdo, M. (1993) Timing of p53 mutations during astrocytoma tumorigenesis.Hum. Mol. Genet. 2(10), 1687–90.PubMedCrossRefGoogle Scholar
  29. 29.
    Rasheed, B.K., McLendon, R.E., Herndon, J.E., Friedman, H.S., Friedman, A.H., Bigner, D.D. and Bigner, S.H. (1994) Alterations of the TP53 gene in human gliomas.Cancer Res. 54(5), 1324–30.PubMedGoogle Scholar
  30. 30.
    Fults, D., Brockmeyer, D., Tullous, M.W., Pedone, C.A. and Cawthon, R.M. (1992) p53 mutation and loss of heterozygosity on chromosomes 17 and 10 during human astrocytoma progression.Cancer Res. 52(3), 674–9.PubMedGoogle Scholar
  31. 31.
    Chozick, B.S., Weicker, M.E., Pezzullo, J.C, Jackson, C.L., Finkelstein, S.D., Ambler, M.W., Epstein, M.H. and Finch, P.W.(1994) Pattern of mutant p53 in human astrocytomas suggests the existence of alternate pathways of tumorigenesis.Cancer 73(2), 406–15.PubMedCrossRefGoogle Scholar
  32. 32.
    Hamilton, S.R., Liu, B., Parsons, R.E., Papadopoulos, N., Jen, J., Powell, S.M., Krush, A.J., Berk, T., Cohen, Z., Tetu, B., Burger, P.C, Wood, P.A., Taqi, F., Booker, S.V., Petersen, G.M., Offerhaus, G.J.A., Tersmette, A.C., Giardiello, F.M., Vogelstein, B. and Kinzler, K. (1995) The molecular basis of Turcot’s syndrome [see comments].N. Engl. J. Med. 332(13), 839–47.PubMedCrossRefGoogle Scholar
  33. 33.
    Groden, J., Thliveris, A., Samowitz, W., Carlson, M., Gelbert, L., Albertsen, H., Joslyn, G., Stevens, J., Spirio, L., Robertson, M., Sargeant, L., Krapcho, K., Wolff, E., Randall, B., Hughes, J.P., Warrington, J., McPherson, J., Wasmuth, J., Le Paslier, D., Abderrahim, H., Cohen, D., Leppert, M. and White, R. (1991) Identification and characterization of the familial adenomatous polyposis coli gene.Cell 66(3), 58–600.CrossRefGoogle Scholar
  34. 34.
    Nishisho, I., Nakamura, Y., Miyoshi, Y., Miki, Y., Ando, H., Horii, A., Koyama, K., Utsunomiya, J., Baba, S. and Hedge, P. (1991) Mutations of chromosome 5q21 genes in FAP and colorectal cancer patients.Science 53(5020), 665–9.CrossRefGoogle Scholar
  35. 35.
    Rubinfeld, B., Souza, B., Albert, I, Muller, O., Chamberlain, SH., Masiarz, F.R., Munemitsu, S. and Polakis, P. (1993) Association of the APC gene product with beta-catenin.Science 262(5140), 1731–4.PubMedCrossRefGoogle Scholar
  36. 36.
    Su, L.K., Vogelstein, B. and Kinzler, K.W. (1993) Association of the APC tumor suppressor protein with catenins.Science 262(5140), 1734–7.PubMedCrossRefGoogle Scholar
  37. 37.
    Peltomaki, P., Aaltonen, L.A., Sistonen, P., Pylkkanen, L., Mecklin, J.P., Jarvinen, H., Green, J.S., Jass, J.R., Weber, J.L., Leach, F.S., Petersen, G.M., Hamilton, S.R., de la Chapelle, A. and Vogelstein, B. (1993) Genetic mapping of a locus predisposing to human colorectal cancer [see comments].Science 260(5109), 810–2.PubMedCrossRefGoogle Scholar
  38. 38.
    Lindblom, A., Tannergard, P., Werelius, B. and Nordenskjold, M. (1993) Genetic mapping of a second locus predisposing to hereditary non-polyposis colon cancer.Nat. Genet. 5(3), 279–82.PubMedCrossRefGoogle Scholar
  39. 39.
    Nicolaides, N.C, Papadopoulos, N., Liu, B., Wei, Y.F., Carter, K.C., Ruben, S.M., Rosen, C.A., Haseltine, W.A., Fleischmann, R.D., Fraser, C.M., Adams, M.D., Venter, J.C., Dunlop, M.G., Hamilton, S.R., Petersen, G.M. and de la Chapelle, A. (1994) Mutations of two PMS homologues in hereditary nonpolyposis colon cancer.Nature 371(6492), 75–80.PubMedCrossRefGoogle Scholar
  40. 40.
    Wallace, M.R., Marchuk, D.A., Andersen, L.B., Letcher, R., Odeh, H.M., Saulino, A.M., Fountain, J.W., Brereton, A., Nicholson, J., Mitchell, A.L., Brownstein, B.H. and Collins, F.S. (1990) Type 1 neurofibromatosis gene: identification of a large transcript disrupted in three NF1 patients [published erratum appears inScience 1990 Dec 21; 250(4988), 1749].Science 249(4965), 181–6.PubMedCrossRefGoogle Scholar
  41. 41.
    Johnson, R.L., Rothman, A.L., Xie, J., Goodrich, L.V., Bare, J.W., Bonifas, J.M., Quinn, A.G., Myers, R.M., Cox, D.R., Epstein, E.H. Jr and Scott, M.P. (1996) Human homolog of patched, a candidate gene for the basal cell nevus syndrome.Science 272(5268), 1668–71.PubMedCrossRefGoogle Scholar
  42. 42.
    Hahn, H., Christiansen, J., Wicking, C, Zaphiropoulos, P.G., Chidambaram, A., Gerrard, B., Vorechovsky, L, Bale, A.E., Toftgard, R., Dean, M. and Wainwright, B. (1996) A mammalian patched homolog is expressed in target tissues of sonic hedgehog and maps to a region associated with developmental abnormalities.J. Biol. Chem. 271(21), 12125–8.PubMedCrossRefGoogle Scholar
  43. 43.
    Shilo, B.Z. (1996) Tumour suppressors. Dispatches from patched [news].Nature 382(6587), 115–6.PubMedCrossRefGoogle Scholar
  44. 44.
    Jones, CE., Davis, M.B., Darling, J.L., Geddes, J.F., Thomas, D.G.T. and Harding, A.E. (1995) Loss of heterozygosity for DNA polymorphisms mapping to chromosomes 10 and 17 and prognosis in patients with gliomas.J. Neurol. Neurosurg. Psychiatry. 58, 218–21.PubMedCrossRefGoogle Scholar
  45. 45.
    von Deimling, A., Nagel, J., Bender, B., Lenarrz, D., Schramm, J., Louis, D.N. and Wiestier, O.D. (1994) Deletion mapping of chromosome 19 in human gliomas.Int. J. Cancer 57(5), 676–80.CrossRefGoogle Scholar
  46. 46.
    Watanabe, K., Nagai, M, Wakai, S., Arai, T. and Kawashima, K. (1990) Loss of constitutional heterozygosity in chromosome 10 in human glioblastoma.Acta Neuropathol. Berl. 80(3), 251–4.PubMedCrossRefGoogle Scholar
  47. 47.
    Mikkelsen, T. (1994) Recent advances in brain tumor molecular biology.Curr. Opin. Oncol. 6(3), 229–34.PubMedCrossRefGoogle Scholar
  48. 48.
    Pershouse, M.A., Stubblefield, E., Hadi, A., Killary, A.M., Yung, W.K. and Steck, P.A. (1993) Analysis of the functional role of chromosome 10 loss in human glioblastomas.Cancer Res. 53(20), 5043–50.PubMedGoogle Scholar
  49. 49.
    Ye, Z., Qu, J.K. and Darras, B.T. (1993) Loss of heterozygosity for alleles on chromosome 10 in human brain tumours.Neurol. Res. 15(1), 59–62.PubMedGoogle Scholar
  50. 50.
    Karlbom, A.E., James, C.D., Boethius, J., Cavenee, W.K., Collins, V.P., Nordenskjold, M. and Larsson, C. (1993) Loss of heterozygosity in malignant gliomas involves at least three distinct regions on chromosome 10.Hum. Genet. 92(2), 169–74.PubMedCrossRefGoogle Scholar
  51. 51.
    James, C.D., Karlbom, E., Dumanski, J.P., Hansen, M., Nordenskjold, M., Collins, V.P. and Cavenee, W.K. (1988) Clonal genomic alterations in glioma malignancy stages.Cancer Res. 48, 5546–51.PubMedGoogle Scholar
  52. 52.
    James, C.D., He, J., Collins, V.P., Allalunis Turner, M.J. and Day, R.S. (1993) Localization of chromosome 9p homozygous deletions in glioma cell lines with markers constituting a continuous linkage group.Cancer Res. 53(16), 3674–6.PubMedGoogle Scholar
  53. 53.
    Olopade, O.I., Jenkins, R.B., Ransom, D.T., Malik, K., Pomykala, H., Nobori, T., Cowan, J.M., Rowley, J.D. and Diaz, M.O. (1992) Molecular analysis of deletions of the short arm of chromosome 9 in human gliomas.Cancer Res. 52(9), 2523–9.PubMedGoogle Scholar
  54. 54.
    Fearon, E. and Vogelstein, B. (1990) A genetic model for colorectal tumorigenesis.Cell 61(5), 759–67.PubMedCrossRefGoogle Scholar
  55. 55.
    Bello, M.J., de Campos, J.M., Kusak, M.E., Vaquero, J., Sarasa, J.L., Pestana, A. and Rey, J.A. (1994) Molecular analysis of genomic abnormalities in human gliomas.Cancer Genet. Cytogenet. 73(2): 122–9.PubMedCrossRefGoogle Scholar
  56. 56.
    Clurman, B.E. and Roberts, J.M. (1995) Cell cycle and cancer [editorial; comment].J. Natl. Cancer Inst. 87(20), 1499–501.PubMedCrossRefGoogle Scholar
  57. 57.
    Schmidt, E.E., Ichimura, K., Reifenberger, G. and Collins, V.P. (1994) CDKN2 (p16/MTSl) gene deletion or CDK4 amplification occurs in the majority of glioblastomas.Cancer Res. 54(24), 6321–4.PubMedGoogle Scholar
  58. 58.
    Jen, J., Harper, J.W., Bigner, S.H., Bigner, D.D., Papadopoulos, N., Markowitz, S., Willson, J.K., Kinzler, K.W. and Vogelstein, B. (1994) Deletion of pl6 and pl5 genes in brain tumors.Cancer Res. 54(24), 6353–8.PubMedGoogle Scholar
  59. 59.
    Reifenberger, G., Liu, L., Ichimura, K., Schmidt, E.E. and Collins, V.P. (1993) Amplification and overexpression of the MDM2 gene in a subset of human malignant gliomas without p53 mutations.Cancer Res. 53(12), 2736–9.PubMedGoogle Scholar
  60. 60.
    Chang, C.H., Horton, J., Schoenfeld, D., Salazer, O., Perez Tamayo, R., Kramer, S., Weinstein, A., Nelson, J.S. and Tsukada, Y. (1983) Comparison of postoperative radiotherapy and combined postoperative radiotherapy and chemotherapy in the multidisciplinary management of malignant gliomas. A joint Radiation Therapy Oncology Group and Eastern Cooperative Oncology Group study.Cancer 52(6), 997–1007.PubMedCrossRefGoogle Scholar
  61. 61.
    Prognostic factors for high-grade malignant glioma: development of a prognostic index. A Report of the Medical Research Council Brain Tumour Working Party. (1990)J. Neurooncol. 9(1), 47–55.CrossRefGoogle Scholar
  62. 62.
    Han, J.S., Bonstelle, CT., Kaufman, B., Benson, J.E., Alfidi, R.J., Clampitt, M., Van Dyke, C., Huss, R.G. (1984) Magnetic resonance imaging in the evaluation of the brainstem.Radiology 150(3): 705–12.PubMedGoogle Scholar
  63. 63.
    Wroe, S.J., Foy, P.M., Shaw, M.D., Williams, I.R., Chadwick, D.W., West, C. and Towns, G. (1986) Neurological and neurosurgical approaches in the management of malignant brain tumours [letter].Br. Med. J. Clin. Res. Ed. 293(6558), 1373.PubMedGoogle Scholar
  64. 64.
    Chamberlain, M.C., Murovic, J.A. and Levin, V.A. (1988) Absence of contrast enhancement on CT brain scans of patients with supratentorial malignant gliomas [published erratum appears inNeurology 1988 Nov;38(ll), 1816].Neurology 38(9), 1371–4.PubMedGoogle Scholar
  65. 65.
    Pedersen, H., Gjerris, F. and Klinken, L. (1989) Malignancy criteria in computed tomography of primary supratentorial tumors in infancy and childhood.Neuroradiology 31(1), 24–8.PubMedGoogle Scholar
  66. 66.
    Gruber, M.L. and Hochberg, F.H. (1990) Systematic evaluation of primary brain rumors [comment].J. Nucl. Med. 31(6), 969–71.PubMedGoogle Scholar
  67. 67.
    Caimcross, J.G., Pexman, J.H., Rathbone, M.P. and Del-Maestro, R.F. (1985) Postoperative contrast enhancement in patients with brain tumor.Ann. Neurol. 17(6), 570–2.CrossRefGoogle Scholar
  68. 68.
    Jeffries, B.F., Kishores, P.R., Singh, K.S., Ghatak, N.R. and Krempa, J. (1981) Contrast enhancement in the postoperative brain.Radiology 139(2), 409–13.PubMedGoogle Scholar
  69. 69.
    Cairncross, J.G., Macdonald, D.R., Pexman, J.H. and Ives, F.J. (1988) Steroid-induced CT changes in patients with recurrent malignant glioma.Neurology 38(5), 724–6.PubMedGoogle Scholar
  70. 70.
    Brooks, DJ., Beaney, R.P., Lammertsma, A.A., Leenders, K.L., Horlock, P.L., Kensett, M.J., Marshall, J., Thomas, D.G. and Jones, T. (1984) Quantitative measurement of blood-brain barrier permeability using rubidium-82 and positron emission tomography.J. Cereb. Blood Flow Metab. 4(4), 535–45PubMedGoogle Scholar
  71. 71.
    Di Chiro, G., DeLaPaz, R.L., Brooks, R.A., Sokoloff, L., Kornblith, P.L., Smith, B.H., Patronas, N.J., Kufta, C.V., Kessler, R.M., Johnston, G.S., Manning, R.G. and Wolf, A.P. (1982) Glucose utilization of cerebral gliomas measured by [18F] fluorodeoxyglucose and positron emission tomography.Neurology 32(12), 1323–9.PubMedGoogle Scholar
  72. 72.
    Francavilla, T.L., Miletich, R.S., Di Chiro, G., Parronas, N.J., Rizzoli, H.V. and Wright, D.C. (1989) Positron emission tomography in the detection of malignant degeneration of low-grade gliomas.Neurosurgery 24(1), 1–5.PubMedCrossRefGoogle Scholar
  73. 73.
    Patronas, N.J., Brooks, R.A., DeLaPaz, R.L., Smith, B.H., Kornblith, P.L. and Di Chiro G. (1983) Glycolytic rate (PET) and contrast enhancement (CT) in human cerebral gliomas.AJNR Am. J. Neuroradiol. 4(3), 533–5.PubMedGoogle Scholar
  74. 74.
    Di Chiro, G., Oldfield, E., Wright, D.C, De Michele, D., Katz, D.A., Patronas, N.J., Doppman, J.L., Larson, S.M., Ito, M. and Kufta, C.V. (1988) Cerebral necrosis after radiotherapy and/or intraarterial chemotherapy for brain rumors: PET and neuropathologic studies.AJR Am. J. Roentgenol. 150(1), 189–97.PubMedGoogle Scholar
  75. 75.
    Patronas, NJ., Di Chiro, G., Brooks, R.A., DeLaPaz, R.L., Kornblith, P.L., Smith, B.H., Rizzoli, H.V., Kessler, R.M., Manning, R.G., Channing, M., Wolf, A.P. and O’Connor, C.M. (1982) Work in progress: [18F] fluorodeoxyglucose and positron emission tomography in the evaluation of radiation necrosis of the brain.Radiology 144(4): 885–9.PubMedGoogle Scholar
  76. 76.
    Valk, P.E., Budinger, T.F., Levin, V.A., Silver, P., Gutin, P.H. and Doyle, W.K. (1988) PET of malignant cerebral tumors after interstitial brachytherapy. Demonstration of metabolic activity and correlation with clinical outcome.J. Neurosurg. 69(6), 830–8.PubMedGoogle Scholar
  77. 77.
    Wahl, R.L., Zasadny, K., Helvie, M., Hutchins, G.D., Weber, B. and Cody, R. (1993) Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation.J. Clin. Oncol. 11(11), 2101–11.PubMedGoogle Scholar
  78. 78.
    Jansson, T., Westlin, J.E., Ahlstrom, H., Lilja, A., Langstrom, B. and Bergh, J. (1995) Positron emission tomography studies in patients with locally advanced and/or meta-static breast cancer: a method for early therapy evaluation?J. Clin. Oncol. 13(6), 1470–7.PubMedGoogle Scholar
  79. 79.
    Holthoff, V.A., Herholz, K., Berthold, F., Widemann, B., Schroder, R., Neubauer, I. and Heiss, W.D. (1993)In vivo metabolism of childhood posterior fossa rumors and primitive neuroectodermal tumors before and after treatment.Cancer 72(4), 1394–403.PubMedCrossRefGoogle Scholar
  80. 80.
    Alavi, J.B., Alavi, A., Chawiuk, J., Kushner, M., Powe, J., Hickey, W. and Reivich, M. (1988) Positron emission tomography in patients with glioma. A predictor of prognosis.Cancer 62(6), 1074–8.PubMedCrossRefGoogle Scholar
  81. 81.
    Patronas, N.J., Di Chiro, G., Kufta, C., Bairamian, D., Kornblith, P.L., Simon, R. and Larson, S.M. (1985) Prediction of survival in glioma patients by means of positron emission tomography.J. Neurosurg. 62(6), 816–22.PubMedGoogle Scholar
  82. 82.
    Fulham, M.J., Bizzi, A., Dietz, M.J., Shih, H.H., Raman, R., Sobering, G.S., Frank, J.A., Dwyer, A.J., Alger, J.R. and Di Chiro, G. (1992) Mapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance.Radiology 185(3), 675–86.PubMedGoogle Scholar
  83. 83.
    Preul, M.C., Caramanos, Z., Collins, D.L., Villemure, J.-G., Leblanc, R., Olivier, A., Pokrupa, R. and Arnold, D.L. (1996) Accurate, noninvasive diagnosis of human brain tumors by using proton magnetic resonance spectroscopy.Nature Med. 2(3), 323–5.PubMedCrossRefGoogle Scholar
  84. 84.
    Kugel, H., Heindel, W., Ernestus, R.I., Bunke, J., du Mesnil, R. and Friedmann G. (1992) Human brain tumors: spectral patterns detected with localized H-l MR spectroscopy.Radiology 183(3), 701–9.PubMedGoogle Scholar
  85. 85.
    Ott, D., Hennig, J. and Ernst, T. (1993) Human brain rumors: assessment within vivo proton MR spectroscopy.Radiology 186(3), 745–52.PubMedGoogle Scholar
  86. 86.
    Thomas, D.G. and Nouby, R.M. (1989) Experience in 300 cases of CT-directed stereotactic surgery for lesion biopsy and aspiration of haematoma.Br. J. Neurosurg. 3(3), 321–5.PubMedCrossRefGoogle Scholar
  87. 87.
    Edwards, M.S., Boggan, J.E. and Fuller, TA. (1983) The laser in neurological surgery.J. Neurosurg. 59(4), 555–66.PubMedGoogle Scholar
  88. 88.
    Ammirati M., Vick, N., Liao, Y.L., Ciric, I. and Mikhael, M. (1987) Effect of the extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic astrocytomas.Neurosurgeny 21(2), 201–6.Google Scholar
  89. 89.
    Winger, M.J., Macdonald, D.R. and Cairncross, J.G. (1989) Supratentorial anaplastic gliomas in adults. The prognostic importance of extent of resection and prior lowgrade glioma.J. Neurosurg. 71(4), 487–93.PubMedGoogle Scholar
  90. 90.
    Wood, J.R., Green, S.B. and Shapiro, W.R. (1988) The prognostic importance of rumor size in malignant gliomas: a computed tomographic scan study by the Brain Tumor Cooperative Group.J. Clin. Oncol. 6(2), 338–43.PubMedGoogle Scholar
  91. 91.
    Walker, M.D., Alexander, E. Jr, Hunt, W.E., MacCarty, C.S., Mahaley, M.S. Jr, Mealey, J. Jr, Norrell, H.A., Owens, G., Ransohoff, J., Wilson, C.B., Gehan, E.A. and Strike, T.A. (1978) Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial.J. Neurosurg. 49(3), 333–43.PubMedGoogle Scholar
  92. 92.
    Walker, M.D., Green, S.B., Byar, D.P., Alexander, E. Jr, Batzdorf, U., Brooks, W.H., Hunt, W.E., MacCarty, C.S., Mahaley, M.S. Jr, Mealey, J. Jr, Owens, G., Ransohoff, J.D., Robertson, J.T., Shapiro, W.R., Smith, K.R. Jr, Wilson, CB. and Strike, T.A. (1980) Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery.N. Engl. J. Med. 303(23), 1323–9.PubMedGoogle Scholar
  93. 93.
    Hochberg, F.H. and Pruitt, A. (1980) Assumptions in the radiotherapy of glioblastoma.Neurology 30(9), 907–11.PubMedGoogle Scholar
  94. 94.
    McComb, R.D. and Burger, P.C. (1985) Pathologic analysis of primary brain tumors.Neurol. Clin. 3(4), 711–28.PubMedGoogle Scholar
  95. 95.
    Walker, M.D., Strike, T.A. and Sheline, G.E. (1979) An analysis of dose-effect relationship in the radiotherapy of malignant gliomas.Int. J. Radiat. Oncol. Biol. Phys. 5(10), 1725–31.PubMedGoogle Scholar
  96. 96.
    Bleehen, N.M. and Stenning, S.P. (1991) A Medical Research Council trial of two radiotherapy doses in the treatment of grades 3 and 4 astrocytoma. The Medical Research Council Brain Tumour Working Party.Br. J. Cancer 64(4), 769–74.PubMedGoogle Scholar
  97. 97.
    Brada, M., Thomas, G., Elyan, S., James, N., Hines, F., Ashley, S., Marsh, H., Bell, B.A. and Stenning, S. (1995) Improving the acceptability of high-dose radiotherapy by reducing the duration of treatment: accelerated radiotherapy in high-grade glioma.Br. J. Cancer 71, 1330–1334PubMedGoogle Scholar
  98. 98.
    Keim, H., Potthoff, P.C., Schmidt, K., Schiebusch, M., Neiss, A. and Trott, K.R. (1987) Survival and quality of life after continuous accelerated radiotherapy of glioblastomas.Radiother. Oncol. 9(1), 21–6.PubMedCrossRefGoogle Scholar
  99. 99.
    Fulton, D.S., Urtasun, R.C., Scott Brown, I., Johnson, E.S., Mielke, B., Curry, B., Huyser Wierenga, D., Hanson, J. and Feldstein, M. (1992) Increasing radiation dose intensity using hyperfractionation in patients with malignant glioma. Final report of a prospective phase I-II dose response study.J. Neurooncol. 14, 63–72.PubMedCrossRefGoogle Scholar
  100. 100.
    Shrieve, D.C., Wara, W.M., Edwards, M.S., Sneed, P.K., Prados, M.D., Cogen, P.H., Larson, D.A. and Levin, V.A. (1992) Hyperfractionated radiation therapy for gliomas of the brainstem in children and in adults.Int. J. Radiat. Oncol. Biol. Phys. 24(4), 599–610.PubMedGoogle Scholar
  101. 101.
    Nelson, D.F., Curran, W.J. Jr, Scott, C., Nelson, J.S., Weinstein, A.S., Ahmad, K., Constine, L.S., Murray, K., Powlis, W.D., Mohiuddin, M. and Fischbach, J. (1993) Hyperfractionated radiation therapy and bis-chlorethyl nitrosourea in the treatment of malignant glioma — possible advantage observed at 72.0 Gy in 1.2 Gy B.I.D. fractions: report of the Radiation Therapy Oncology Group Protocol 8302.Int. J. Radiat. Oncol. Biol. Phys. 25, 193–207.PubMedGoogle Scholar
  102. 102.
    Deutsch, M., Green, S.B., Strike, T.A., Burger, P.C., Robertson, J.T., Selker, R.G., Shapiro, W.R., Mealey, J. Jr, Ransohoff, J.D., Paoletti, P., Smith, K.R. Jr, Odom, G.L., Hunt, W.E., Young, B., Alexander, E. Jr, Walker, M.D. and Pistenmaa, D.A. (1989) Results of a randomized trial comparing BCNU plus radiotherapy, streptozotocin plus radiotherapy, BCNU plus hyperfractionated radiotherapy, and BCNU following misonidazole plus radiotherapy in the postoperative treatment of malignant glioma.Int. J. Radiat. Oncol. Biol. Phys. 16(6), 1389–96.PubMedGoogle Scholar
  103. 103.
    Loeffler, J.S., Siddon, R.L., Wen, P.Y., Nedzi, L.A. and Alexander, E. (1990) Stereotactic radiosurgery of the brain using a standard linear accelerator: a study of early and late effects.Radiother. Oncol. 17, 311–21.PubMedCrossRefGoogle Scholar
  104. 104.
    Chamberlain, M.C., Barba, D., Kormanik, P. and Shea, W.M. (1994) Stereotactic radiosurgery for recurrent gliomas.Cancer 74: 1342–7.PubMedCrossRefGoogle Scholar
  105. 105.
    Sarkaria, J.N., Mehta, M.P., Loeffler, J.S., Buatti, J.M., Chappell, R.J., Levin, A.B., Alexander, E., Friedman, W.A. and Kinsella, T.J. (1995) Radiosurgery in the initial management of malignant gliomas: survival comparison with the RTOG recursive partitioning analysis. Radiation Therapy Oncology Group.Int. J. Radiat. Oncol. Biol. Phys. 32(4), 931–41.PubMedGoogle Scholar
  106. 106.
    Pan, D.H., Guo, W.Y., Chung, W.Y., Shiau, C.Y., Liu, R.S. and Lee, L.S. (1995) Early effects of Gamma Knife surgery on malignant and benign intracranial tumors.Stereotact. Fund. Neurosurg. 64 Suppl 1, 19–31.CrossRefGoogle Scholar
  107. 107.
    Laws, E.R. Jr, Cortese, D.A., Kinsey, J.H., Eagan, R.T. and Anderson, R.E. (1981) Photoradiation therapy in the treatment of malignant brain tumors: a phase I (feasibility) study.Neurosurgery 9(6), 672–8.PubMedCrossRefGoogle Scholar
  108. 108.
    EORTC Brain Tumour Group. (1983) Misonidazole in radiotherapy of supratentorial malignant brain gliomas in adult patients: a randomized double-blind study.Eur. J. Cancer Clin. Oncol. 19(1), 39–42.CrossRefGoogle Scholar
  109. 109.
    Nelson, D.F., Schoenfeld, D., Weinstein, A.S., Nelson, J.S., Wasserman, T., Goodman, R.L. and Carabell, S. (1983) A randomized comparison of misonidazole sensitized radiotherapy plus BCNU and radiotherapy plus BCNU for treatment of malignant glioma after surgery; preliminary results of an RTOG study.Int. J. Radiat. Oncol. Biol. Phys. 9(8), 1143–51.PubMedGoogle Scholar
  110. 110.
    Bleehen, N.M. (1980) The Cambridge glioma trial of misonidazole and radiation therapy with associated pharmacokinetic studies.Cancer Clin. Trials 3(3), 267–73.PubMedGoogle Scholar
  111. 111.
    Fulton, D.S., Urtasun, R.C., Shin, K.H., Geggie, P.H., Thomas, H., Muller, P.J., Moody, J., Tanasichuk, H., Mielke, B., Johnson, E. and Curry, B. (1984) Misonidazole combined with hyperfractionation in the management of malignant glioma.Int. J. Radiat. Oncol. Biol. Phys. 10, 1709–12.PubMedGoogle Scholar
  112. 112.
    Duncan, W. (1994) An evaluation of the results of neutron therapy trials.Acta Oncol. 33(3), 299–306.PubMedCrossRefGoogle Scholar
  113. 113.
    Philips, T.L., Levin, V.A., Ahn, D.K., Gutin, P.H., Davis, R.L., Wilson, C.B., Prados, M.D., Wara, W.M. and Flam, M.S. (1991) Evaluation of bromodeoxyuridine in glioblastoma multiforme: a Northern California Cancer Center Phase II study [see comments].Int. J. Radiat. Oncol. Biol. Phys. 21(3), 709–14.Google Scholar
  114. 114.
    Jackson, D., Kinsella, T., Rowland, J., Wright, D., Katz, D., Main, D., Collins, J., Kornblith, P. and Glatstein, E. (1987) Halogenated pyrimidines as radiosensitizers in the treatment of glioblastoma multiforme.Am. J. Clin. Oncol. 10, 437–81.PubMedCrossRefGoogle Scholar
  115. 115.
    Laing, R.W., Warrington, A.P., Graham, J., Britton, J., Hines, F. and Brada, M. (1993) Efficacy and toxicity of fractionated stereotactic radiotherapy in the treatment of recurrent gliomas (phase I/II study).Radiother. Oncol. 27. 22–9.PubMedCrossRefGoogle Scholar
  116. 116.
    Loeffler, J.S., Alexander, E.D., Wen, P.Y., Shea, W.M., Coleman, C.N., Kooy, H.M., Fine, H.A., Nedzi, L.A., Silver, B., Riese, N.E. and Black, P.M.L. (1990) Results of stereotactic brachytherapy used in the initial management of patients with glioblastoma.J. Natl. Cancer Inst. 82, 1918–21.PubMedCrossRefGoogle Scholar
  117. 117.
    Gutin, P.H., Leibel, S.A., Wara, W.M., Choucair, A., Levin, V.A., Philips, T.L., Silver, P., Da Silva, V., Edwards, M.S., Davis, R.L., Weaver, K.A. and Lamb, S. (1987) Recurrent malignant gliomas: survival following interstitial brachytherapy with high-activity iodine-125 sources [published erratum appears inJ. Neurosurg. 1988 June; 68(6), 990].J. Neurosurg. 67(6), 864–73.PubMedGoogle Scholar
  118. 118.
    Dische, S. (1991) A review of hypoxic cell radiosensitization.Int. J. Radiat. Oncol. Biol. Phys. 20(1), 147–52.PubMedGoogle Scholar
  119. 119.
    Shapiro, J.R., Pu, P.Y., Mohamed, A.N., Galicich, J.H., Ebrahim, S.A. and Shapiro, W.R. (1993) Chromosome number and carmustine sensitivity in human gliomas.Cancer 71(12), 4007–21.PubMedCrossRefGoogle Scholar
  120. 120.
    Fine, H.A., Dear, K.B., Loeffler, J.S., Black, P.M. and Canellos, G.P. (1993) Meta-analysis of radiation therapy with and without adjuvant chemotherapy for malignant gliomas in adults [see comments].Cancer 71(8), 2585–97.PubMedCrossRefGoogle Scholar
  121. 121.
    Stenning, S.P., Freedman, L.S. and Bleehen, N.M. (1987) An overview of published results from randomized studies of nitrosoureas in primary high grade malignant glioma [letter].Br. J. Cancer 56(1), 89–90.PubMedGoogle Scholar
  122. 122.
    Tait, D.M., Thornton Jones, H., Bloom, HJ., Lemerle, J. and Morris Jones, P. (1990) Adjuvant chemotherapy for medulloblastoma: the first multi-centre control trial of the International Society of Paediatric Oncology (SIOP I).Eur. J. Cancer 26(4), 464–9.PubMedGoogle Scholar
  123. 123.
    Evans, A.E., Jenkin, R.D., Sposto, R., Ortega, J.A., Wilson, C.B., Wara, W., Ertel, I.J., Kramer, S., Chang, C.H., Leikin, S.L. and Hammond, G.D. (1990) The treatment of medulloblastoma. Results of a prospective randomized trial of radiation therapy with and without CCNU, vincristine, and prednisone.J. Neurosurg. 72(4), 572–82.PubMedGoogle Scholar
  124. 124.
    Levin, V.A., Silver, P., Hannigan, J., Wara, W.M., Gutin, P.H., Davis, R.L. and Wilson, C.B. (1990) Superiority of post-radiotherapy adjuvant chemotherapy with CCNU, procarbazine, and vincristine (PCV) over BCNU for anaplastic gliomas: NCOG 6G61 final report.Int. J. Radiat. Oncol. Biol. Phys. 18(2), 321–4.PubMedGoogle Scholar
  125. 125.
    Levin, V.A., Prados, M.R., Wara, W.M., Davis, R.L., Gutin, P.H., Phillips, T.L., Lamborn, K. and Wilson, C.B. (1995) Radiation therapy and bromodeoxyuridine chemotherapy followed by procarbazine, lomustine, and vincristine for the treatment of anaplastic gliomas.Int. J. Radiat. Oncol. Biol. Phys. 32(1), 75–83.PubMedGoogle Scholar
  126. 126.
    Fingert, HJ. and Hochberg, F.H. (1984) Megadose chemotherapy with bone marrow rescue.Prog. Exp. Tumor Res. 28, 67–78.PubMedGoogle Scholar
  127. 127.
    Mbidde, E.K., Selby, P.J., Perren, T.J., Dearnaley, D.P., Whitton, A., Ashley, S., Workman, P., Bloom, H.J. and McElwain, T.J. (1988) High dose BCNU chemotherapy with autologous bone marrow transplantation and full dose radiotherapy for grade IV astrocytoma.Br. J. Cancer 58(6), 779–82.PubMedGoogle Scholar
  128. 128.
    Fine, H.A. and Antman, K.H. (1992) High-dose chemotherapy with autologous bone marrow transplantation in the treatment of high grade astrocytomas in adults: therapeutic rationale and clinical experience.Bone Marrow Transplant 10(4), 315–21.PubMedGoogle Scholar
  129. 129.
    Garfield, J. and Dayan, A.D. (1973) Postoperative intracavitary chemotherapy of malignant gliomas. A preliminary study using methotrexate.J. Neurosurg. 39(3), 315–22.PubMedGoogle Scholar
  130. 130.
    Garfield, J., Dayan, A.D. and Weiler, R.O. (1975) Postoperative intracavitary chemotherapy of malignant supratentorial astrocytomas using BCNU.Clin. Oncol. 1(3), 213–22.PubMedGoogle Scholar
  131. 131.
    Bouvier, G., Penn, R.D., Kroin, J.S., Beique, R. and Guerard, M.J. (1987) Direct delivery of medication into a brain tumor through multiple chronically implanted catheters.Neurosurgery 20(2), 286–91.PubMedCrossRefGoogle Scholar
  132. 132.
    Nierenberg, D., Harbaugh, R., Maurer, L.H., Reeder, T., Scott, G., Fratkin, J. and Newman, E. (1991) Continuous intratumoral infusion of methotrexate for recurrent glioblastoma: a pilot study.Neuwsurgery 28(5), 752–61.CrossRefGoogle Scholar
  133. 133.
    Brem, K, Mahaley, M.S. Jr, Vick, N.A., Black, K.L., Schold, S.C. Jr, Burger, P.C., Friedman, A.H., Ciric, I.S., Eller, T.W., Cozzens, J.W. and Kenealy, J.N. (1991) Interstitial chemotherapy with drug polymer implants for the treatment of recurrent gliomas.J. Neurosurg. 74(3), 441–6.PubMedGoogle Scholar
  134. 134.
    Brem, H., Ewend, M.G., Piantadosi, S., Greenhoot, J., Burger, P.C. and Sisti, M. (1995) The safety of interstitial chemotherapy with BCNU-loaded polymer followed by radiation therapy in the treatment of newly diagnosed malignant gliomas: phase I trial.J. Neurooncol. 26(2), 111–23.PubMedCrossRefGoogle Scholar
  135. 135.
    O’Reilly, S.M., Newlands, E.S., Glaser, M.G., Brampton, M., Rice Edwards, J.M., Illingworth, R.D., Richards, P.G., Kennard, C., Colquhoun, I.R., Lewis, P. and Stevens, M.F.G. (1993) Temozolomide: a new oral cytotoxic chemotherapeutic agent with promising activity against primary brain tumours [published erratum appears inEur. J. Cancer 1993;29A(10), 1500].Eur. J. Cancer 29a(7): 940–2.PubMedCrossRefGoogle Scholar
  136. 136.
    Lesser, G.J. and Grossman, S. (1994) The chemotherapy of high-grade astrocytomas.Semin. Oncol. 21(2), 220–35.PubMedGoogle Scholar
  137. 137.
    Tishler, R.B., Geard, C.R., Hall, E.J. and Schiff, P.B. (1992) Taxol sensitizes human astrocytoma cells to radiation.Cancer Res. 52(12), 3495–7.PubMedGoogle Scholar
  138. 138.
    Tishler, R.B., Schiff, P.B., Geard, C.R. and Hall, E.J. (1992) Taxol: a novel radiation sensitizer.Int. J. Radiat. Oncol. Biol. Phys. 22(3), 613–7.PubMedGoogle Scholar
  139. 139.
    Hei, T.K. and Hall, E.J. (1993) Taxol, radiation, and oncogenic transformation.Cancer Res. 53(6), 1368–72.PubMedGoogle Scholar
  140. 140.
    Culver, K.W. and Blaese, R.M. (1994) Gene therapy for cancer.Trends Genet. 10(5), 174–8.PubMedCrossRefGoogle Scholar
  141. 141.
    Culver, K.W., Ram, Z., Wallbridge, S., Ishii, H., Oldfield, E.H. and Blaese, R.M. (1992)In vivo gene transfer with retroviral vector-producer cells for treatment of experimental brain tumors [see comments].Science 256(5063), 1552–2.CrossRefGoogle Scholar
  142. 142.
    Yu, J.S., Wei, MX, Chiocca, E.A., Martuza, R.L. and Tepper, R.I. (1993) Treatment of glioma by engineered interleukin 4-secreting cells.Cancer Res. 53(13), 3125–8.PubMedGoogle Scholar
  143. 143.
    Morrison, R.S., Giordano, S., Yamaguchi, F., Hendrickson, S., Berger, M.S. and Palczewski, K. (1993) Basic fibroblast growth factor expression is required for clonogenic growth of human glioma cells.J. Neurosci. Res. 34(5), 502–9.PubMedCrossRefGoogle Scholar
  144. 144.
    Ciric, I., Ammirati, M., Vick, N. and Mikhael, M. (1987) Supratentorial gliomas: surgical considerations and immediate postoperative results. Gross total resection versus partial resection.Neurosurgery 21(1), 21–6.PubMedCrossRefGoogle Scholar
  145. 145.
    Aaronson, N.K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N.J., Filiberti, A., Hechtner, H., Fleishman, S.B., de Haes, J.C., Kaasa, S., Klee, M., Osaba, D., Razavi, D., Rofe, P.B., Schraub, S., Sneeuw, K., Sullivan, M. and Takeda, F. (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology.J. Natl. Cancer Inst. 85(5), 365–76.PubMedCrossRefGoogle Scholar
  146. 146.
    Newlands, E.S., Blackledge, G.R., Slack, J.A., Rustin, G.J., Smith, D.B., Stuart, N.S., Quarterman, C.P., Hoffman, R., Stevens, M.F., Brampton, M.H. and Gibson, A.C. (1992) Phase I trial of temozolomide (CCRG 81045: M&B 39831: NSC 362856).Br. J. Cancer 65(2), 287–91.PubMedGoogle Scholar
  147. 147.
    Vasantha Kumar, A.R., Renaudin, J., Wilson, C.B., Boldrey, E.B., Enot, K.J. and Levin, V.A. (1974) Procarbazine hydrochloride in the treatment of brain tumors. Phase 2 study.J. Neurosurg. 40(3), 365–71.PubMedGoogle Scholar
  148. 148.
    Stewart, D.J., Grahovac, Z., Hugenholtz, H., Russell, N., Richard, M. and Benoit, B. (1987) Combined intraarterial and systemic chemotherapy for intracerebral tumors.Neuwsurgery 21(2), 207–14.Google Scholar
  149. 149.
    Mahaley, M.S. Jr, Hipp, S.W., Dropcho, E.J., Bertsch, L., Cush, S., Tirey, T. and Gillespie, G.Y. (1989) Intracarond cisplarin chemotherapy for recurrent gliomas.J. Neurosurg. 70(3), 371–8.PubMedGoogle Scholar
  150. 150.
    Longee, D.C., Friedman, H.S., Albright, R.E. Jr, Burger, P.C., Oakes, W.J., Moore, J.O. and Schold, S.C. Jr. (1990) Treatment of patients with recurrent gliomas with cyclophosphamide and vincristine.J. Neurosurg. 72(4), 583–8.PubMedGoogle Scholar
  151. 151.
    Yung, W.K., Mechtler, L. and Gleason, M.J. (1991) Intravenous carboplatin for recurrent malignant glioma: a phase II study.J. Clin. Oncol. 9(5), 860–4.PubMedGoogle Scholar
  152. 152.
    Frenay, M., Giroux, B., Khoury, S., Derlon, J.M. and Namer, M. (1991) Phase II study of fotemustine in recurrent supratentorial malignant gliomas.Eur. J. Cancer 27(7), 852–6.PubMedCrossRefGoogle Scholar
  153. 153.
    Gumerlock, M.K., Belshe, B.D., Madsen, R. and Watts, C. (1992) Osmotic blood-brain barrier disruption and chemotherapy in the treatment of high grade malignant glioma: patient series and literature review.J. Neurooncol. 12(1), 33–46.PubMedCrossRefGoogle Scholar
  154. 154.
    Dropcho, E.J., Rosenfeld, S.S., Morawetz, R.B., Vitek, J., Brothers, M., Gorum, T., Bell, S., Gillespie, G.Y., Glantz, M., Mahaley, M.S. Jr. and Schold, S.C. Jr. (1992) Preradiation intracarotid cisplatin treatment of newly diagnosed anaplastic gliomas. The CNS Cancer Consortium.J. Clin. Oncol. 10(3), 452–8.PubMedGoogle Scholar
  155. 155.
    Priestman, T.J., Bleehen, N.M., Rampling, R., Stenning, S., Nethersell, A.J. and Scott, J. (1993) A phase II evaluation of human lymphoblastoid interferon (Wellferon) in relapsed high grade malignant glioma. Medical Research Council Brain Tumour Working Party.Clin. Oncol. R. Coll. Radiol. 5(3), 165–8.PubMedGoogle Scholar
  156. 156.
    Cairncross, G., Macdonald, D., Ludwin, S., Lee, D., Cascino, T., Buckner, J., Fulton, D., Dropcho, E., Stewart, D., Schold, C. Jr, Wainman, N. and Eisenhauer, E. (1994) Chemotherapy for anaplastic oligodendroglioma. National Cancer Institute of Canada Clinical Trials Group.J. Clin. Oncol. 12(10), 2013–21.PubMedGoogle Scholar
  157. 157.
    Stewart, DJ., Dahrouge, S. and Soltys, K. (1995) A phase II study of 5-fluorouraciI plus folinic acid in malignant gliomas in adults.J. Neurooncol. 23(3), 249–52.PubMedCrossRefGoogle Scholar
  158. 158.
    Brem, H., Piantadosi, S., Burger, P.C., Walker, M., Selker, R., Vick, N.A., Black, K., Sisti, M., Brem, S., Mohr, G., Muller, P., Morawetz, R. and Schold, S.C. (1995) Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. The Polymer-brain Tumor Treatment Group [see comments].Lancet 345(8956), 1008–12.PubMedCrossRefGoogle Scholar
  159. 159.
    Couldwell, W.T., Hinton, D.R., Surnock, A.A., DeGiorgio, CM., Weiner, L.P., Apuzzo, M.L.J., Masri, L., Law, R.E. and Weiss, M.H. (1996) Treatment of recurrent malignant gliomas with chronic oral high-dose tamoxifen.Clin. Cancer Res. 2, 619–22.PubMedGoogle Scholar
  160. 160.
    Sanson, M., Ameri, A., Monjour, A., Sahmoud, T., Ronchin, P., Poisson, P. and Delattre, J.Y. (1996) Treatment of recurrent malignant supratentorial gliomas with ifosfamide, Carboplatin and Etoposide: a phase II study.Eur. J. Cancer 32A(13), 2229–35.PubMedCrossRefGoogle Scholar
  161. 161.
    Yung, W.K.A., Kyritsis, A.P., Gleason, M.J. and Levin, V.A. (1996) Treatment of recurrent malignant gliomas with high-dose 13-cis-retinoic acid.Clin. Cancer Res. 2, 1931–5.PubMedGoogle Scholar
  162. 162.
    Chauveinc, L., Sola Martinez, M.T., Martin Duvemeuil, M., Mazeron, J.J., Faillot, T., Cornu, P., Capelle, L., Delattre, J.Y., Poisson, M., Baillet, F. and Chiras, J. (1996) Intra arterial chemotherapy with ACNU and radiotherapy in inoperable malignant gliomas.J. Neurooncol. 27(2), 141–7.PubMedCrossRefGoogle Scholar
  163. 163.
    Hildebrand, J., Sahmoud, T., Mignolet, F., Brucher, J.M. and Afra, D. (1994) Adjuvant therapy with dibromodulcitol and BCNU increases survival of adults with malignant gliomas. EORTC Brain Tumor Group.Neurology 44(8), 1479–83.PubMedGoogle Scholar
  164. 164.
    Shapiro, W.R., Green, S.B., Burger, P.C., Selker, R., VanGilder J.C., Robertson, J.T., Mealey, J. Jr, Ranshoff, J. and Mahaley, M.S. Jr. (1992) A randomized comparison of intra-arterial versus intravenous BCNU, with or without intravenous 5-fluorouracil, for newly diagnosed patients with malignant glioma.J. Neurosurg. 76(5), 772–81.PubMedGoogle Scholar
  165. 165.
    Barba, D., Saris, S.C., Holder, C., Rosenberg, S.A. and Oldfield, E.H. (1989) Intrarumoral LAK cell and inter-leukin-2 therapy of human gliomas. J. Neurosurg.70(2), 175–82.PubMedGoogle Scholar
  166. 166.
    Riva, P., Arista, A., Tison, V., Sturiale, C, Franceschi, G., Spinelli, A., Riva, N., Casi, M., Moscatelli, G. and Frattarelli, M. (1994) Intralesionai radioimmunotherapy of malignant gliomas. An effective treatment in recurrent tumors.Cancer 73(3 Suppl), 1076–82.PubMedCrossRefGoogle Scholar
  167. 167.
    Stragliotto, G., Vega, F., Stasiecki, P., Gropp, P., Poisson, M. and Delattre, J.Y. (1996) Multiple infusions of anti-epidermal growth factor receptor (EGFR) monoclonal antibody (EMD 55,900) in patients with recurrent malignant gliomas.Eur. J. Cancer 32a(4), 636–40.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 1997

Authors and Affiliations

  • C. S. Brock
    • 1
  • M. Bower
    • 1
  1. 1.Medical Oncology UnitCharing Cross HospitalLondonUK

Personalised recommendations