[Malignant gliomas in adult. Interest of immediate radiotherapy in the combined protocols : chemotherapy (VM26-CCNU), radiotherapy. A cooperative study on 137 cases (author's transl)].

The results of a multicentric study of three combined therapeutic protocols for malignant gliomas are reported. The goal was the evaluation of "Delayed" versus "Immediate" Radiotherapy. All patients were operated on, the radiotherapy was 5 800 rad. whole brain. The drugs used were : Day 1 - Day 2 Epipodophylotoxine 60 mg/m2/day. Day 3 - Day 4 CCNU 60 mg/m2/day. The mean survival times were : "total" surgery versus "partial" surgery: "total" group : 52 cases - mean survival : 44 weeks ; "partial" group : 60 cases - mean survival : 48 weeks : 1) protocol A : surgery + chemotherapy alone : 60 patients/34 weeks ; 2) protocol B : surgery + radiotherapy + chemotherapy :22 patients/43 weeks ; 3) protocol C : surgery + chemotherapy 4 cycles + radiotherapy + chemotherapy : 51 patients/71 weeks. The percentage of survivors at 12 months was Prot. A : 57% - Prot. B : 32% - Prot. C : 70%. These results are in favor of "Delayed" radiotherapy. They are statistically significant, and prompt us to pursue such a trial for getting confirmation upon numerically broader groups of patients.