[Response factors in the treatment of malignant gliomas in the adult (author's transl)].

: A statistical study was used to determine the significant prognostic factors in a protocol containing surgery, radiotherapy and polychemotherapy applied to 121 consecutive unselected patients suffering from malignant gliomas. The histological grade of the malignant tumor, the age of the patient and the neurological state if it could be evaluated after surgery appeared to be significant. It is therefore possible to suggest a clinical classification into three groups. Group 1 consists of patients aged 50 or less and a postoperative neurological state of 1 or 2 according to Order's classification; group 2 consists of patients with one pejorative factor, i.e. aged over 50 or a postoperative neurological state of 3 or 4; group 3 is those patients with two pejorative factors (aged over 50 and postoperative neurological state of 3 or 4) or aged 65 or over. Methods of application of treatment are also involved in the therapeutic response: Excision surgery appears to be essential. It improves the duration and quality of survival and influences the efficacy of combined radio-chemotherapy. By contrast, the effects of cobalt and chemotherapy must be envisaged in an efficacy/tolerance ratio which is difficult to evaluate, but for which the suggested clinical classification as a certain indicative value. Finally, the various factors lead to an approach to the concept of therapeutic responses and to determine within the total population of malignant gliomas various categories of patients in whom the profile is defined both by clinical characteristics and the tolerance of treatment and in whom different treatment techniques must be envisaged.