# Radiation Oncology/RTOG Trials/8302

RTOG 83-02 (BRAIN/GLIOMA)
    Radiation Oncology/CNS/RTOG Brain
* Conclusion:
** PMID 8608540;1996 -- Final report of a phase I/II trial of hyperfractionated and accelerated hyperfractionated radiation therapy with carmustine for adults with supratentorial malignant gliomas. Radiation Therapy Oncology Group Study 83-02. (Werner-Wasik M, Cancer. 1996 Apr 15;77(8):1535-43.) Conclusion: "The use of HF with BCNU and dose escalation up to 81.6 Gy is both feasible and tolerable, although late toxicity increases slightly with increasing dose. The best MST with the least toxicity were observed for AA in the lower received HF doses (72 and 64.8 Gy). Accordingly, 72 Gy in two 1.2 Gy fractions was used as the investigational arm of a completed Phase III trial (RTOG 90-06). In contrast, for GBM patients, longer survival times were noted in the higher received HF doses (78.6 and 81.6 Gy), suggesting the role for further dose escalation. The low toxicity rate with AHF arms suggest that further dose escalation is possible and is currently occurring in RTOG 94-11."
* Publications:
** ASTRO Abstract 2003 -- Reexamining the Radiation Therapy Oncology Group (RTOG) Recursive Partitioning Analysis (RPA) for Glioblastoma Multiforme (GBM) Patients (Shaw E, Proc Am Soc Thera Rad Oncol (ASTRO), Salt Lake City, UT, Int J Radiat Oncol Biol Phys, [57] (2) pg. S135-136, Abs. #20, 2003.)
*** Also: 7401, 7918, 9006, 9411
** SNO Abstract 2003 -- Ethnic Differences in Survival of Glioblastoma (GBM): A Secondary Analysis of the Radiation Therapy Oncology Group (RTOG) Recursive Partitioning Analysis (RPA) Database. (Shaw E, Proc from Soc for Neuro-Oncology (SNO), Keystone, Colorado, Neuro-Oncol, [5] (4) pg. 296-297, Abs. #EP-14, 2003.)
*** Also: 7401, 7918, 9006, 9411
** ASTRO Abstract 2002 -- Overexpression of the Epidermal Growth Factor Receptor (Egfr), as Determined by EGFR Immunostaining on Tissue Microarrays, Fails to Demonstrate Prognostic Value for Patients with Glioblastoma Multiforme: A Report from RTOG 74-01, 79-18, 83-02, 84-09, 90-06, 93-05, 96-02, and 98-06. (Seiferheld W, Proc Am Soc Thera Rad Oncol (ASTRO), New Orleans, LA, Int J Radiat Oncol Biol Phys, [54] (2) pg. 96, Abs. #161, 2002.)
*** Also: 7401, 7918, 8409, 9006, 9305, 9602, 9806
** PMID 10550132; 1999 -- Procarbazine, lomustine, and vincristine (PCV) chemotherapy for anaplastic astrocytoma: A retrospective review of radiation therapy oncology group protocols comparing survival with carmustine or PCV adjuvant chemotherapy. (Prados MD, J Clin Oncol. 1999 Nov;17(11):3389-95.) Conclusion: "Using this retrospective analysis, there does not seem to be any survival benefit to PCV chemotherapy. Future phase III studies for patients with AA may need to consider whether BCNU or PCV is used in the control arm."
*** Also: 70-18, 90-06
** PMID 8625107; 1995 -- Central pathology review in clinical trials for patients with malignant glioma. A Report of Radiation Therapy Oncology Group 83-02. (Scott CB, Cancer. 1995 Jul 15;76(2):307-13.) Conclusion: "This examination of a central versus an institutional pathology review demonstrates a low level of agreement on AAF classification and a high level of concordance on GBM classification. The results indicate the need to adjust sample size for trials of both AAF and GBM tumors to have adequate statistical power. A central pathology review remains essential for trial entry for patients with AAF and could be omitted for trials enrolling patients with GBM only."
** PMID 7852106; 1995 -- Quality-adjusted survival analysis of malignant glioma. Patients treated with twice-daily radiation (RT) and carmustine: a report of Radiation Therapy Oncology Group (RTOG) 83-02. (Murray KJ, Int J Radiat Oncol Biol Phys. 1995 Feb 1;31(3):453-9.) Conclusion: "This quality-adjusted survival methodology can be successfully applied to malignant glioma patients and permits a quantitative assessment of the influence of investigational therapies on patient quality of life. This analysis confirms the potential benefit of intermediate dose (72.0 Gy) hyperfractionated RT for selected malignant glioma patients."
** PMID 7954244; 1994 -- White matter changes are correlated significantly with radiation dose. Observations from a randomized dose-escalation trial for malignant glioma (Radiation Therapy Oncology Group 83-02). (Corn BW, Cancer. 1994 Nov 15;74(10):2828-35.) Conclusion: "A well described toxicity scale for white matter injury was applied successfully to patients with malignant glioma treated with definitive irradiation. Severe white matter changes continued to increase significantly as the total dose of hyperfractionated cranial irradiation was escalated. The time to onset of the white matter abnormalities appeared to be independent of dose. An ongoing Radiation Therapy Oncology Group study will allow correlation of white matter injury with prospective neuropsychometric testing."
** PMID 8487050; 1993 -- Survival comparison of radiosurgery-eligible and -ineligible malignant glioma patients treated with hyperfractionated radiation therapy and carmustine: a report of Radiation Therapy Oncology Group 83-02. (Curran WJ, J Clin Oncol. 1993 May;11(5):857-62.) Conclusion: "SRS-eligible patients enrolled on RTOG 83-02 had survival superior to that of the SRS-ineligible group, and this advantage is mainly due to the selection of a subgroup with a high minimum KPS."
** PMID 8478956; 1993 -- Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. (Curran WJ Jr, J Natl Cancer Inst. 1993 May 5;85(9):704-10.)
** PMID 8387988; 1993 -- Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: results of three consecutive Radiation Therapy Oncology Group (RTOG) clinical trials. (Simpson J, Int J Radiat Oncol Biol Phys. 1993 May 20;26(2):239-44.) Conclusion: "We conclude that biopsy only yields inferior survival to more extensive surgery for patients with glioblastoma multiforme treated with surgery and radiation therapy."
*** Also: 74-01, 79-18
** PMID 8380567; 1993 -- Hyperfractionated radiation therapy and bis-chlorethyl nitrosourea in the treatment of malignant glioma--possible advantage observed at 72.0 Gy in 1.2 Gy B.I.D. fractions: report of the Radiation Therapy Oncology Group Protocol 8302. (Nelson DF, Int J Radiat Oncol Biol Phys. 1993 Jan 15;25(2):193-207.) Conclusion: "Patients with anaplastic astrocytoma treated with 72 Gy by hyperfractionation + BCNU had at least as good a survival as those treated with 60 Gy by conventional fractionation + BCNU on Radiation Therapy Oncology Group protocols 7401 and 7918. This suggests that 72 Gy delivered by 1.2 Gy twice daily is no more toxic than 60 Gy delivered by conventional fractionation."
** PMID 1451073; 1992 -- A randomized trial of accelerated hyperfractionated radiation therapy and bis-chloroethyl nitrosourea for malignant glioma. A preliminary report of Radiation Therapy Oncology Group 83-02. (Curran WJ Jr, Cancer. 1992 Dec 15;70(12):2909-17.) Conclusion: "The maximum tolerated dose of AHRT has yet to be identified, and pursuit of this information may most benefit patients with malignant glioma who are 60 years of age or older."