Glioblastoma Multiforme-Reply

In Reply. In Reply—— Although we agree that further controlled and prospective studies are needed in the search for improved treatment of malignant brain tumors, recent additional evidence supports our contention that the nitrosoureas are valuable in such therapy. Walker and Strike1have now reported a median survival time of 51 weeks in patients treated with both radiation therapy and carmustine in a recent BTSG protocol. Furthermore, even in the previous protocol, in which carmustine failed to increase significantly the median survival time over that obtained with radiation therapy alone, 23% of the patients who received both modes of treatment survived 18 months, while only 5% of those receiving radiation therapy without carmustine survived as long.2With respect to lomustine, results in our recent studies3differ from those of the Mayo Clinic group.4We combined lomustine on a twice-monthly schedule with procarbazine and vincristine and obtained a median survival time