Abstract
Background. Children diagnosed with medulloblastoma whose tumor involves the brain stem or has spread through the cerebrospinal fluid pathways to other areas of the brain or spinal cord have a poor prognosis despite therapy with surgery, craniospinal irradiation (CSI), and chemotherapy. Preradiation chemotherapy may improve the outlook for these patients. Methods. To further study the role and feasibility of preradiation chemotherapy, children between the ages of 4 and 21 years diagnosed with advanced medulloblastoma and measurable disease were enrolled in the Pediatric Oncology Group 8695 study. Patients were treated with a 9-week course of vincristine, cisplatin, and cyclophosphamide followed by CSI. Imaging films were reviewed centrally for eligibility and response to chemotherapy. Toxicity to chemotherapy and radiation as well as delays and modifications in subsequent CSI were recorded. Results. Thirteen of 30 fully evaluable patients achieved complete or partial response (43%) to chemotherapy. Toxicity was mostly fever and neutropenia after cyclophosphamide, which is predictable and tolerable. Radiation therapy was delivered in full doses and volumes in most patients but was delayed in its start in most patients. Central review of films revealed frequent use of different imaging modalities at baseline and after therapy, making accurate assessment of tumor response difficult. Conclusion. Preradiation chemotherapy with vincristine, cisplatin, and cyclophosphamide is active in patients with advanced medulloblastoma but should be modified to minimize the risk of progressive disease while on therapy and to avoid delays in starting radiation therapy. Consistent use of the same neuroimaging modality is essential in documenting response.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2755-2762 |
| Number of pages | 8 |
| Journal | Cancer |
| Volume | 72 |
| Issue number | 9 |
| DOIs | |
| State | Published - 1993 |
| Externally published | Yes |
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Keywords
- adolescence
- brain neoplasms
- child
- cisplatin
- combined modality therapy
- cyclophosphamide
- drug evaluation
- medulloblastoma
- radiation therapy
- vincristine
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Preradiation chemotherapy in advanced medulloblastoma : A Pediatric Oncology Group pilot study. / Mosijczuk, A. D.; Nigro, M. A.; Thomas, P. R M; Burger, P. C.; Krischer, J. P.; Morantz, R. A.; Kurdunowicz, B.; Mulne, A. F.; Towbin, R. B.; Freeman, A. I.; Nigro, E. D.; Friedman, H. S.; Kun, L. E.
In: Cancer, Vol. 72, No. 9, 1993, p. 2755-2762.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Preradiation chemotherapy in advanced medulloblastoma
T2 - A Pediatric Oncology Group pilot study
AU - Mosijczuk, A. D.
AU - Nigro, M. A.
AU - Thomas, P. R M
AU - Burger, P. C.
AU - Krischer, J. P.
AU - Morantz, R. A.
AU - Kurdunowicz, B.
AU - Mulne, A. F.
AU - Towbin, R. B.
AU - Freeman, A. I.
AU - Nigro, E. D.
AU - Friedman, H. S.
AU - Kun, L. E.
PY - 1993
Y1 - 1993
N2 - Background. Children diagnosed with medulloblastoma whose tumor involves the brain stem or has spread through the cerebrospinal fluid pathways to other areas of the brain or spinal cord have a poor prognosis despite therapy with surgery, craniospinal irradiation (CSI), and chemotherapy. Preradiation chemotherapy may improve the outlook for these patients. Methods. To further study the role and feasibility of preradiation chemotherapy, children between the ages of 4 and 21 years diagnosed with advanced medulloblastoma and measurable disease were enrolled in the Pediatric Oncology Group 8695 study. Patients were treated with a 9-week course of vincristine, cisplatin, and cyclophosphamide followed by CSI. Imaging films were reviewed centrally for eligibility and response to chemotherapy. Toxicity to chemotherapy and radiation as well as delays and modifications in subsequent CSI were recorded. Results. Thirteen of 30 fully evaluable patients achieved complete or partial response (43%) to chemotherapy. Toxicity was mostly fever and neutropenia after cyclophosphamide, which is predictable and tolerable. Radiation therapy was delivered in full doses and volumes in most patients but was delayed in its start in most patients. Central review of films revealed frequent use of different imaging modalities at baseline and after therapy, making accurate assessment of tumor response difficult. Conclusion. Preradiation chemotherapy with vincristine, cisplatin, and cyclophosphamide is active in patients with advanced medulloblastoma but should be modified to minimize the risk of progressive disease while on therapy and to avoid delays in starting radiation therapy. Consistent use of the same neuroimaging modality is essential in documenting response.
AB - Background. Children diagnosed with medulloblastoma whose tumor involves the brain stem or has spread through the cerebrospinal fluid pathways to other areas of the brain or spinal cord have a poor prognosis despite therapy with surgery, craniospinal irradiation (CSI), and chemotherapy. Preradiation chemotherapy may improve the outlook for these patients. Methods. To further study the role and feasibility of preradiation chemotherapy, children between the ages of 4 and 21 years diagnosed with advanced medulloblastoma and measurable disease were enrolled in the Pediatric Oncology Group 8695 study. Patients were treated with a 9-week course of vincristine, cisplatin, and cyclophosphamide followed by CSI. Imaging films were reviewed centrally for eligibility and response to chemotherapy. Toxicity to chemotherapy and radiation as well as delays and modifications in subsequent CSI were recorded. Results. Thirteen of 30 fully evaluable patients achieved complete or partial response (43%) to chemotherapy. Toxicity was mostly fever and neutropenia after cyclophosphamide, which is predictable and tolerable. Radiation therapy was delivered in full doses and volumes in most patients but was delayed in its start in most patients. Central review of films revealed frequent use of different imaging modalities at baseline and after therapy, making accurate assessment of tumor response difficult. Conclusion. Preradiation chemotherapy with vincristine, cisplatin, and cyclophosphamide is active in patients with advanced medulloblastoma but should be modified to minimize the risk of progressive disease while on therapy and to avoid delays in starting radiation therapy. Consistent use of the same neuroimaging modality is essential in documenting response.
KW - adolescence
KW - brain neoplasms
KW - child
KW - cisplatin
KW - combined modality therapy
KW - cyclophosphamide
KW - drug evaluation
KW - medulloblastoma
KW - radiation therapy
KW - vincristine
UR - http://www.scopus.com/inward/record.url?scp=0027495426&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027495426&partnerID=8YFLogxK
U2 - 10.1002/1097-0142(19931101)72:9<2755::AID-CNCR2820720937>3.0.CO;2-V
DO - 10.1002/1097-0142(19931101)72:9<2755::AID-CNCR2820720937>3.0.CO;2-V
M3 - Article
C2 - 8402500
AN - SCOPUS:0027495426
VL - 72
SP - 2755
EP - 2762
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 9
ER -