The title doesn’t exactly roll off the tongue, but that won’t
make the article that Keith Stelzer, M.D., Ph.D.,co-authored and the medical
industry’s most prestigious journal recently published any less
“Radiation plus Procarbazine, CCNU, and Vincristine in Low-Grade
Glioma” reports the results of a study conducted by a nationwide
group of researchers, including Dr. Stelzer, exploring the effectiveness
of a new method of treating a particular tumor called a glioma. The article
appeared in the April 7, 2016, edition of “The New England Journal
of Medicine,” the most widely read and cited medical journal.
Dr. Stelzer spent the first part of his medical career heavily involved
in research while on the faculty of the University of Washington, and
he has continued to be involved in a variety of studies while directing
the radiation oncology department of Celilo Cancer Center. He has authored
several articles for other medical journals, but this is the first time
his name has appeared on the pages of the NEJM.
“This particular paper’s importance to me is that it represents
something with potentially far-reaching impact in the care of patients,something
that tends to be a fairly rare event over an individual’s career
studying cancer therapies,” Dr. Stelzer says.
This study actually began in the late 1990s, when Dr. Stelzer was still
at the University of Washington and also chaired the Brain Tumor Committee
for the Southwest Oncology Group. Its goal was to attempt to determine
if the addition of a chemotherapy regimen (called PCV) to radiation treatment
could improve survival rates when compared to radiation therapy alone
for patients with low-grade gliomas, a type of tumor that originates from
cells in the brain.
The researchers did find their method improved survival rates; however,
Dr. Stelzer says, while the study was taking place a new drug, called
temozolomide, was introduced in the care of glioma patients that may be
“This illustrates some of the difficulties with cancer research,
particularly when studying tumor types like gliomas that are less common,”
he says. “It can take a long time to enroll enough patients to be
able to detect statistically meaningful results. As a result, newer methods
of treatment can come along, and physician practice patterns can change.”
Dr. Stelzer says the publishing of this study’s results will mean
cancer physicians will have to decide between two proven effective methods
of treating gliomas.
“Nobody knows for certain whether patients with low-grade gliomas
should receive PCV or temozolomide,” he says.“But my guess
is most will receive temozolomide because it is easier to deliver and
well tolerated by patients.