{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:13:05Z","timestamp":1791270785995,"version":"4.1.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1978,9]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 A controlled, prospective, randomized study evaluated the use of 1,3-bis(2-chloroethyl)-l-nitrosourea (BCNU) and\/or radiotherapy in the treatment of patients who were operated on and had histological confirmation of anaplastic glioma. A total of 303 patients were randomized into this study, of whom 222 (73%) were within the Valid Study Group (VSG), having met the protocol criteria of neuropathology, corticosteroid control, and therapeutic approach. Patients were divided into four random groups, and received BCNU (80 mg\/sq m\/day on 3 successive days every 6 to 8 weeks), and\/or radiotherapy (5000 to 6000 rads to the whole brain through bilateral opposing ports), or best conventional care but no chemotherapy or radiotherapy. Analysis was performed on all patients who received any amount of therapy (VSG) and on the Adequately Treated Group (ATG), who had received 5000 or more rads radiotherapy, two or more courses of chemotherapy, and had a minimum survival of 8 or more weeks (the interval that would have been required to have received either the radiotherapy or chemotherapy). Median survival of patients in the VSG was, best conventional care: 14 weeks (ATG: 17.0 weeks); BCNU: 18.5 weeks (ATG: 25.0 weeks); radiotherapy: 35 weeks (ATG: 37.5 weeks); and BCNU plus radiotherapy: 34.5 weeks (ATG: 40.5 weeks). All therapeutic modalities showed some statistical superiority compared to best conventional care. There was no significant difference between the four groups in relation to age distribution, sex, location of tumor, diagnosis, tumor characteristics, signs or symptoms, or the amount of corticosteroid used. An analysis of prognostic factors indicates that the initial performance status (Karnofsky rating), age, the use of only a surgical biopsy, parietal location, the presence of seizures, or the involvement of cranial nerves II, III, IV, and VI are all of significance. Toxicity included acceptable, reversible thrombocytopenia and leukopenia.<\/jats:p>","DOI":"10.3171\/jns.1978.49.3.0333","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:25:00Z","timestamp":1241709900000},"page":"333-343","source":"Crossref","is-referenced-by-count":1317,"title":["Evaluation of BCNU and\/or radiotherapy in the treatment of anaplastic gliomas"],"prefix":"10.3171","volume":"49","author":[{"given":"Michael D.","family":"Walker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eben","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Hunt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collin S.","family":"MacCarty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Stephen","family":"Mahaley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mealey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horace A.","family":"Norrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Owens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Ransohoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles B.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund A.","family":"Gehan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Strike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"489","DOI":"10.3171\/jns.1958.15.5.0489","article-title":"Glioblastoma multiforme. Review of 219 cases with regard to natural history, pathology, diagnostic methods and treatment.","volume":"15","author":"Frankel","year":"1958"},{"key":"b2","series-title":"Biometrika","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1093\/biomet\/52.1-2.203","article-title":"A generalized Wilcoxon test for comparing arbitrarily singly-censored samples.","volume":"52","author":"Gehan","year":"1965"},{"key":"b3","series-title":"J Natl Cancer Inst","article-title":"Prognostic factors for patients with brain tumors.","author":"Gehan"},{"key":"b4","series-title":"Cancer Treat Rev","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/S0305-7372(74)80016-2","article-title":"Glioblastoma multiforme \u2014 a review of therapy.","volume":"1","author":"Goldsmith","year":"1974"},{"key":"b5","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"388","DOI":"10.3171\/jns.1967.27.5.0388","article-title":"The treatment of glioblastoma multiforme of the brain.","volume":"27","author":"Jelsma","year":"1967"},{"key":"b6","series-title":"J Am Stat Assoc","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1080\/01621459.1958.10501452","article-title":"Nonparametric estimation from incomplete observations.","volume":"53","author":"Kaplan","year":"1958"},{"key":"b7","series-title":"Arch Intern Med","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1001\/archinte.1951.03810040002001","article-title":"Triethylene melamine in the treatment of neoplastic disease.","volume":"87","author":"Karnofsky","year":"1951"},{"key":"b8","series-title":"Semin Oncol","first-page":"57","article-title":"A pharmacologic basis for brain tumor chemotherapy.","volume":"2","author":"Levin","year":"1975"},{"key":"b9","series-title":"J Natl Cancer Inst","article-title":"Neuropathology observations on tissues from patients treated by the Brain Tumor Study Group (BTSG).","author":"Mahaley"},{"key":"b10","series-title":"Tumors of the Central Nervous System.","author":"Rubinstein","year":"1972"},{"key":"b11","series-title":"Pathology of Tumours of the Nervous System","author":"Russell","year":"1970"},{"key":"b12","series-title":"Cancer Res","first-page":"725","article-title":"Experimental evaluation of potential anticancer agents. VIII. Effects of certain nitrosoureas on intracerebral L1210 leukemia.","volume":"23","author":"Schabel","year":"1963"},{"key":"b13","series-title":"Statistical Methods","first-page":"215","author":"Snedecor","year":"1967"},{"key":"b14","series-title":"Cancer Res","first-page":"827","article-title":"Evaluation of antileukemic agents employing advanced leukemia L1210 in mice. VIII.","volume":"24","author":"Vendetti","year":"1964"},{"key":"b15","series-title":"Cancer Medicine.","first-page":"1385","article-title":"Brain and peripheral nervous system tumors","author":"Walker","year":"1973"},{"key":"b16","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"655","DOI":"10.3171\/jns.1976.44.6.0655","article-title":"The evaluation of mithramycin in the treatment of anaplastic gliomas.","volume":"44","author":"Walker","year":"1976"},{"key":"b17","series-title":"Cancer Chemother Rep","first-page":"263","article-title":"BCNU 1,3-bis(2-chloroethyl)-1-nitrosourea; (NSC-409962) in the treatment of malignant brain tumor \u2014 a preliminary report.","volume":"54","author":"Walker","year":"1970"},{"key":"b18","series-title":"Proc Am Assoc Cancer Res","first-page":"163","article-title":"An evaluation of Methyl-CCNU, BCNU and radiotherapy in the treatment of malignant glioma.","volume":"17","author":"Walker","year":"1976"},{"key":"b19","series-title":"Cancer Chemother Rep","first-page":"273","article-title":"1,bis(2-chloroethyl)-1-nitrosourea (NSC-409962) in the treatment of brain tumors.","volume":"54","author":"Wilson","year":"1970"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/49\/3\/article-p333.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/49\/3\/article-p333.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/49\/3\/article-p333.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T18:16:36Z","timestamp":1660500996000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/49\/3\/article-p333.xml"}},"subtitle":["A cooperative clinical trial"],"short-title":[],"issued":{"date-parts":[[1978,9]]},"references-count":19,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns.1978.49.3.0333","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1978,9]]}}}