Details

Autor(en) / Beteiligte

• JENNINGS, Mark T
• SPOSTO, Richard
• ETTINGER, Lawrence J
• FITZ, Charles R
• LAFOND, Deborah
• MANDELBAUM, David E
• MASSEY, Vicky
• MCGUIRE, Warren
• MCNEELY, Lee
• MOULTON, Thomas
• POLLACK, Lan F
• SHEN, Violet
• BOYETT, James M
• VEZINA, L. Gilbert
• HOLMES, Emi
• BERGER, Mitchell S
• BRUGGERS, Carol S
• BRUNER, Janet M
• CHAN, Ka-Wah
• DUSENBERY, Kathryn E

Titel

Preradiation Chemotherapy in Primary High-Risk Brainstem Tumors: Phase II Study CCG-9941 of the Children’s Cancer Group

Ist Teil von

• Journal of clinical oncology, 2002-08, Vol.20 (16), p.3431-3437

Ort / Verlag

Baltimore, MD: American Society of Clinical Oncology

Erscheinungsjahr

2002

Quelle

MEDLINE

Beschreibungen/Notizen

• This Children's Cancer Group group-wide phase II trial evaluated the efficacy and toxicity of two chemotherapy arms administered before hyperfractionated external-beam radiotherapy (HFEBRT). Thirty-two patients with newly diagnosed brainstem gliomas were randomly assigned to regimen A and 31 to regimen B. Regimen A comprised three courses of carboplatin, etoposide, and vincristine; regimen B comprised cisplatin, etoposide, cyclophosphamide, and vincristine. Both arms included granulocyte colony-stimulating factor. Patients were evaluated by magnetic resonance imaging after induction chemotherapy and HFEBRT at a dose of 72 Gy. Ten percent +/- 5% of regimen A patients objectively responded to chemotherapy. For combined induction and radiotherapy, 27% +/- 9% of patients improved. The neuroradiographic response rate for regimen B was 19% +/- 8% for chemotherapy and 23% +/- 9% after HFEBRT. Response rates were not statistically significant between regimens after induction or chemotherapy/HFEBRT. Event-free survival was 17% +/- 5% (estimate +/- SE) at 1 year and 6% +/- 3% at 2 years. Survival was significantly longer among patients who responded to chemotherapy (P <.05). Among patients who received regimen A induction, grades 3 and 4 leukopenia were observed in 50% to 65%, with one toxicity-related death. For regimen B, severe leukopenia occurred in 86% to 100%, with febrile neutropenia in 48% to 60% per course. Neither chemotherapy regimen meaningfully improved response rate, event-free survival, or overall survival relative to previous series of patients with brainstem gliomas who received radiotherapy with or without chemotherapy.