Criteria for evaluating patients undergoing chemotherapy for malignant brain tumors

Abstract

Criteria for evaluating brain tumor patients were evaluated, and a numerical rating scale was devised to designate response to testing. The reliability of test combinations that permit accurate prediction of response or deterioration during therapy was discussed in experience with 100 patients. The paper summarizes the predictive value of the neurological examination, radionuclide scintiscan computerized tomographic brain scan (CT scan) and EEG, in the determination of response (tumor regression) or deterioration (tumor growth) during brain tumor chemotherapy and chemotherapy-radiotherapy. By retrospective analysis, the neurological examination, radionuclide scintiscan and CT scan were of equal value individually as tests to predict response to therapy. The prognostic values of the neurological examination or radionuclide scintiscan were moderately superior to the CT scan in predicting deterioration during therapy. Under circumstances whereby a neurological examination, radionuclide scintiscan and CT scan were performed during the same testing session, and steroid dosage was carefully monitored, 2 of the 3 tests accurately predicted deterioration in 65% of patients, and response to therapy in 82% of patients. Two of the 3 tests correctly established deterioration in the remaining 35% of patients, and response in the remaining 18% of patients, when the 2 positively correlated tests occurred within a mean period of 7 wk.