[Delayed results of using a new collagen-polyester dural prosthesis]. / Odlegle spostrzezenia uzycia kolagenowo-poliestrowego substytutu opony twardej.

A new dural prosthesis was prepared by bilateral coating of polyester net with radiation-modified collagen. Prosthesis is smooth highly flexible, water resistant and 0.3 mm thick. In the Department of Neurosurgery, Warsaw Medical Academy, Poland, 11 patients had a new dural prosthesis implanted, 1 with posttraumatic CSF-leakage and 10 with intracranial neoplasms. Early observation (2 to 4 weeks) and delayed (7 to 23 months) were performed. Neither allergic nor inflammatory reactions were observed. No CSF-leakage was observed. A new Polish dural substitute seems to be better than other ones because of its similarity to natural dura mater and low price.

Quality of survival of patients with brain gliomas treated with postoperative CCNU and radiation therapy.

This prospective randomized clinical trial compared the effectiveness of combined treatment with CCNU and radiation therapy to the use of radiation therapy alone for the postoperative management of supratentorial brain gliomas (67% anaplastic) in 198 patients. The results were evaluated with the aid of a specially developed weighted neuropsychological test battery providing single-value estimation of "life quality" of patients, as well as with a clinical performance scale. Based on these methods, it was established that patients improved within 6 months following therapy. This improvement was maintained in surviving patients during the 2-year follow-up period. The patients led a relatively normal life, but when their condition deteriorated their decline was rapid. The median survival time of patients treated with radiotherapy did not differ significantly from that of patients receiving chemotherapy in addition. Nor did the analysis of life quality and of changes in clinical performance show any benefit in supplementing surgery and radiation therapy with CCNU chemotherapy at the dosage used.

Postoperative radiotherapy and radiotherapy combined with CCNU chemotherapy for treatment of brain gliomas.

A prospective, randomized trial evaluates the effects of two postoperative treatment regimens on survival in 198 adult patients with supratentorial gliomas. All patients were irradiated with 6,000 rads after possibly radical removal of tumors. CCNU administration in the doses of 100 mg/sq m of body surface every 6-8 weeks following surgery proved to have no significant effect on the survival of patients. The median survival time in patients receiving radiation therapy alone was 61 +/- 7 weeks, while in those receiving additional chemotherapy was 56 +/- 4 weeks. Tumor histological malignancy and patients age were found to be the only important prognostic factors, irrespective of the treatment modality.

[Analysis of the results of combined treatment of poorly differentiated brain gliomas]. / Ocena wyników skojarzonego leczenia niskozróznicowanych glejaków mózgu.

In a group of 139 patients with poorly differentiated brain gliomas controlled clinical trial was carried out for assessment of two methods of postoperative treatment. After possibly radical removal of the glioma the patients were treated by radiotherapy with 60Co teletherapy in doses of 60 Gy (30 fr) in depth during 6 weeks, and randomly chosen patients received also CCNU in one dose of 100 mg/m repeated at intervals of 6-8 weeks. The administration of CCNU failed to improve the therapeutic results. The median survival time in the whole group was 49 weeks. The survival rate after 1, 2 and 3 years was 45.4%, 22.8% and 14.9% respectively. The survival times of cases of glioblastoma multiforme were not significantly different from those of patients with other poorly differentiated gliomas independently of the treatment method. The complications were not troublesome.