The Authors, after briefly reviewing the literature on chemotherapy of malignant gliomas, present their own experience on forty-four patients with such tumors. All of them had been previously operated and irradiated. The clinical course was controlled by various parameters which are described. Results obtained in glioblastomas, anaplastic astrocytomas and malignant oligodendrogliomas are discussed. BCNU and CCNU seem to be beneficial not only in prolonging survival time but also in improving its quality: the average survival time of treated patients is 9.2 +/- 9.8 against 6.7 +/- 3.4 of controls. These values however are not statistically significant. In 15 out of 31 patients, who died at varying intervals after chemoterapy, an autopsy was performed. The morphology of the tumors was compared with that of previous biopsies. No specific alterations to be referred to chemotherapy were found. The side effects are described in detail and particular attention is focused on toxicity (blood and liver) whose main effect is the lowering of platelets and white cells. However, this and the epatic alterations did not reach values requiring interruption of chemotherapy. Other drugs have been used such as MeCCNU, VM 26 and Procarbazine. The number of patients, treated with each of them, is low for a definite conclusion; even if VM 26 and Procarbazine seem to offer the best effects.

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