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February 1977

Glioblastoma Multiforme

Arch Neurol. 1977;34(2):131. doi:10.1001/archneur.1977.00500140085021

To the Editor.—  In a recent issue of the Archives (33:494, 1976), Drs Shapiro and Young recommended that patients with glioblastoma multiforme "have a major resection followed by a combination of chemotherapy with carmustine and vincristine plus radiotherapy." Unfortunately, the combination of carmustine and vincristine sulfate has little to recommend it either in logic or in fact.The Brain Tumor Study Group (BTSG) has shown that postoperative radiotherapy significantly prolongs survival in patients with glioblastoma multiforme.1.2 However, the data from both the BTSG and the Mayo Clinic group3 have failed to show any significant difference in the length of survival time between patients who received postoperative radiotherapy plus chemotherapy vs those who received radiotherapy alone. The objective evidence that routine postoperative chemotherapy with lomustine or carmustine contributes to patient survival or well-being is weak. Shapiro and Young provide no new meaningful data to show whether or not chemotherapy