Abstract
Ten patients who had undergone surgery for malignant astrocytoma were studied to evaluate the effect of immunochemoradiation therapy on postoperative tumor volume. The patient's average age was 64.8 years, and the mean preoperative Karnof sky performance rating was 76%. Eight patients had glioblastoma and two patients had anaplastic astrocytoma. Tumor volumes before and after surgery were compared using computer tomographic and magnetic resonance imaging scans with contrast enhancement and a micro-computer-assisted image analysis system. In five patients, tumor volume decreased or was unchanged (effective group), and in another five patients tumor volume increased (ineffective group) . The proliferative activity of the tumor was examined by staining of argyrophilic nucleolar organizer regions (AgNORs) . The mean number of AgNORs was 2.67 in the effective group and 2.61 in the ineffective group. Differences between the two groups in preoperative tumor volume, residual tumor volume, survival time, mean number of AgNORs, and the percentage of nuclear area occupied by AgNORs (% A/N) were examined by the Mann-Whitney U test. There was no significant difference between the two groups in proliferative potential. Only postoperative residual tumor volume was significantly different between the two groups (p<0.05) . In the effective group the postoperative tumor volume was less than 10 cm3. Therefore, extensive surgery in which postoperative residual tumor volume is less than 10 cm3 may increase the efficacy of postoperative immunochemoradiation therapy and may be the most important component of the same multidisciplinary therapy.
