PREIRRADIATION CHEMOTHERAPY WITH CARBOPLATIN AND ETOPOSIDE IN NEWLY-DIAGNOSED EMBRYONAL PEDIATRIC CNS TUMORS

被引:52
作者
HEIDEMAN, RL
KOVNAR, EH
KELLIE, SJ
DOUGLASS, EC
GAJJAR, AJ
WALTER, AW
LANGSTON, JA
JENKINS, JJ
LI, YL
GREENWALD, C
SANFORD, RA
KUN, LE
机构
[1] ST JUDE CHILDRENS RES HOSP, DEPT NEUROL, MEMPHIS, TN 38101 USA
[2] ST JUDE CHILDRENS RES HOSP, DEPT DIAGNOST IMAGING, MEMPHIS, TN 38101 USA
[3] ST JUDE CHILDRENS RES HOSP, DEPT PATHOL, MEMPHIS, TN 38101 USA
[4] ST JUDE CHILDRENS RES HOSP, DEPT BIOSTAT, MEMPHIS, TN 38101 USA
[5] ST JUDE CHILDRENS RES HOSP, DEPT RADIAT ONCOL, MEMPHIS, TN 38101 USA
[6] UNIV TENNESSEE, COLL MED, DEPT PEDIAT, MEMPHIS, TN USA
[7] UNIV TENNESSEE, COLL MED, DIV PEDIAT NEUROSURG, MEMPHIS, TN USA
[8] UNIV TENNESSEE, COLL MED, DEPT RADIAT ONCOL, MEMPHIS, TN USA
[9] UNIV TENNESSEE, COLL MED, DEPT PATHOL, MEMPHIS, TN USA
关键词
D O I
10.1200/JCO.1995.13.9.2247
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: We evaluated the clinical efficacy of preirradiation carboplatin (CARBO) and etoposide (VP-16) in 25 patients with newly diagnosed embryonal CNS tumors. Patients and Methods: Sixteen patients with high-risk medulloblastoma and nine with other embryonal tumors were treated with two daily doses of CARBO 350 mg/m(2) and VP-16 100 mg/m(2) (CARBO/VP) every 21 days for four cycles before standard craniospinol irradiation. Patients with disease progression (PD) before radiation therapy were additionally treated with intensive postirradiation cyclophosphamide (CYCLO) and vincristine (VINC). Results: Among 23 assessable patients, 48% (95% confidence interval, 27% to 69%) herd a complete response (CR) or partial response (PR) to CARBO/VP; eight had PD. Among the subgroup of 15 assessable patients with medulloblastoma, 53% had a CR or PR (95% confidence interval, 27% to 79%) and five PD. The toxicity of CARBO/VP was predominantly hematologic; although grade IV neutropenia was common, only five episodes of febrile neutropenia occurred. Only thrombocytopenia was a more common toxicity than in other reported chemotherapy regimens; ototoxicity wets less common than in cisplatin (CDDP) regimens. Conclusion: The responses and survival associated with neoadjuvant CARBO/VP are similar to those with CDDP-containing and other neoadjuvant drug regimens. Although the rate of progression with this regimen may be higher than with similar CDDP-containing regimens, the numbers of patients in other published studies of these agents are too small to detect meaningful statistical differences, Future studies must balance the apparently comparable efficacy of CARBO and CDDP with their differing toxicities. (C) 1995 by American Society of Clinical Oncology.
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收藏
页码:2247 / 2254
页数:8
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