Adding chemotherapy to standard radiation treatment can boost survival for patients with an aggressive form of brain cancer that usually kills within months of diagnosis, new study findings show.
Nearly three times as many patients were still alive after two years with the combination treatment than with radiation alone, according to results presented here Monday at the annual meeting of the American Society of Clinical Oncology.
“This treatment clearly improved overall survival,” said study author Dr. Roger Stupp of the University Hospital Mutidisciplinary Oncology Center in Lausanne, Switzerland.
The patients had glioblastoma multiforme, the most common and most aggressive type of brain cancer that is considered incurable. It is diagnosed in about 18,400 Americans each year and kills nearly 13,000 annually.
“Patients usually die within less than one year,” Stupp said.
Chemotherapy can make a difference
Radiation treatment after surgery to remove a tumor has been the standard treatment for these patients for three decades, Stupp noted. The new findings are the first to show that chemotherapy can make a difference when given in combination with radiation.
“This will probably change the standard of care,” Stupp said.
While not a cure, he said, the findings offer new hope for a notoriously difficult and deadly cancer.
“These are pretty good-looking data,” commented Dr. Frank Haluska, a cancer specialist at Massachusetts General Hospital in Boston.
The study involved almost 575 patients, ages 18 to 70, treated at more than 80 centers in Europe, Canada and Australia. Half were given standard radiation treatment after surgery to remove their tumors, while the other half were given both radiation and chemotherapy with the oral drug temozolomide.
Results showed that 26 percent of patients who received chemotherapy survived at least two years, compared with 10 percent in the other group. Patients on chemotherapy also saw their disease progress more slowly.
'It is progress'
While a 26 percent survival rate may not seem terrific, Haluska noted, it’s nearly three times as long as with standard treatment, and for a very deadly disease.
“It is progress,” he said.
Stupp said the chemo drug was well-tolerated by patients, generally only causing “mild to moderate” side effects such as fatigue and nausea.
Another study presented at the meeting showed that chemotherapy may also help patients with less common brain cancers called gliomas.
Researchers in the United States and Canada found that adding the drugs procarbazine, lomustine and vincristine to radiation therapy slowed the advance of the disease, which took about 2.6 years to progress in this group versus 1.9 years in the group receiving radiation alone.
But the chemo combination did not prolong overall survival in the study of almost 300 patients, who lived a median of about 4.5 years, reported Dr. Gregory Cairncross of the University of Calgary.
However, patients with certain genetic mutations in chromosomes 1 and 19 lived longer, regardless of their treatment.