Twenty-eight patients who were previously treated by aggressive surgery and
radiation and were diagnosed with supratentorial malignant gliomas receive
d a combination of nimustine hydrochloride; 1-(4-amino-2-methyl-5-pyrimidin
yl) methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU), cisplatin
and etoposide (ACE therapy) as primary treatment. Cisplatin and etoposide w
ere given at doses of 20 and 60 mg/m(2)/day for 5 days, respectively, ACNU
doses 80 mg/m(2)/day on the first day. Treatment was repeated at 4-week int
ervals for up to 3 cycles. Seventeen patients (60.7%) complained of nausea.
Grade 3 or 4 hematological toxicity occurred in 11 patients (39.3%), and g
rade 3 or 4 renal toxicity occurred in 2 patients. The percentage of patien
ts who showed complete or partial response was 28.6% (8/28). The median tim
e of tumor progression was 40 weeks, and the median survival time was 146 w
eeks. There were some long-surviving patients who may have benefited from A
CE combination. This study demonstrated the effects of ACE combination in p
atients with supratentorial malignant gliomas.