Multidisciplinary Therapy for Malignant Glioma

Clinical results over ten years

抄録

A multidisciplinary therapy combining surgery, irradiation, chemotherapy (ACNU) and immunotherapy (0K-432) was used for patients with malignant glioma, diagnosed with the aid of CT. Fifty-seven adult patients with primary supertentorial astrocytoma were treated 1979 and 1990. Histological diagnosis resulted in the following classifications: Grade II: 19 cases; Grade III: 13 cases; Grade IV: 25 cases. The therapeutic schedule was divided into two types: A) surgery and irradiation; B) surgery, irradiation, ACNU (2mg/kg,1-2 times via carotid arterial injection), and OK-432. Leu-3a/2a with flow cytometry was used as the immunological index.
A survival rate of 5 years was seen in 58% of the Grade II, and 22% of the Grade III/IV astrocytoma patients. Mean survival time by treatment schedule (Kaplan/Meier method) was 66.5 months for Group A and 73.8 months for Group B for Grade II, and 38.4 months for Group A and 46.9 months for Group B for Grade III/IV.
Mean survival time by age was 86.6 months for patients younger than 49 and thatby operative methods was 79.1 months for patients undergoing subtotal removal. Immunological deficiency was improved with the use of OK-432. For patients with malignant glioma, a multidiscriplinary therapy in combination with Co irradiation, ACNU, and OK-432 was more effective than conventional irradiation therapy for prolonging the patients' life.