Rutkowski, S. and Bode, U. and Deinlein, F. and Ottensmeier, H. and Warmuth-Metz, M. and Soerensen, N. and Graf, N. and Emser, A. and Pietsch, T. and Wolff, Johannes E. A. and Kortmann, R. D. and Kuehl, J. (2005) Treatment of early childhood medulloblastoma by postoperative chemotherapy alone. NEW ENGLAND JOURNAL OF MEDICINE, 352 (10). pp. 978-986. ISSN 0028-4793,
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND: The prognosis for young children with medulloblastoma is poor, and survivors are at high risk for cognitive deficits. We conducted a trial of the treatment of this brain tumor by intensive postoperative chemotherapy alone. METHODS: After surgery, children received three cycles of intravenous chemotherapy (cyclophosphamide, vincristine, methotrexate, carboplatin, and etoposide) and intraventricular methotrexate. Treatment was terminated if a complete remission was achieved. Leukoencephalopathy and cognitive deficits were evaluated. RESULTS: Forty-three children were treated according to protocol. In children who had complete resection (17 patients), residual tumor (14), and macroscopic metastases (12), the five-year progression-free and overall survival rates (+/-SE) were 82+/-9 percent and 93+/-6 percent, 50+/-13 percent and 56+/-14 percent, and 33+/-14 percent and 38+/-15 percent, respectively. The rates in 31 patients without macroscopic metastases were 68+/-8 percent and 77+/-8 percent. Desmoplastic histology, metastatic disease, and an age younger than two years were independent prognostic factors for tumor relapse and survival. Treatment strategies at relapse were successful in 8 of 16 patients. There were no major instances of unexpected toxicity. In 19 of 23 children, asymptomatic leukoencephalopathy was detected by magnetic resonance imaging. After treatment, the mean IQ was significantly lower than that of healthy controls within the same age group but higher than that of patients in a previous trial who had received radiotherapy. CONCLUSIONS: Postoperative chemotherapy alone is a promising treatment for medulloblastoma in young children without metastases.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MALIGNANT BRAIN-TUMORS; STUDY-GROUP ANZCCSG; YOUNG-CHILDREN; PREIRRADIATION CHEMOTHERAPY; MOPP CHEMOTHERAPY; INFANTS; IRRADIATION; RADIATION; AGE; PATTERNS; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Kinder- und Jugendmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 18 May 2021 10:26 |
| Last Modified: | 18 May 2021 10:26 |
| URI: | https://pred.uni-regensburg.de/id/eprint/36375 |
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