High-dose carboplatin, thiotepa, and etoposide with autologous stem-cell rescue for patients with recurrent medulloblastoma. Children's Cancer Group
| Autor: | Allan J. Yates, Sharon Gardner, Marc K. Rosenblum, Hao Li, Stewart Goldman, Bruce C. Bostrom, Leonard S. Sender, James M. Boyett, Jonathan L. Finlay, Ira J. Dunkel, James Garvin, Jeffrey C. Allen |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Autologous Stem Cell Rescue Adolescent medicine.medical_treatment Hematopoietic stem cell transplantation ThioTEPA Transplantation Autologous Carboplatin chemistry.chemical_compound Antineoplastic Combined Chemotherapy Protocols medicine Humans Cerebellar Neoplasms Child Etoposide Chemotherapy business.industry Hematopoietic Stem Cell Transplantation Infant Recurrent Medulloblastoma Combined Modality Therapy Survival Analysis Surgery Transplantation Oncology chemistry Child Preschool Female Neoplasm Recurrence Local business Thiotepa Medulloblastoma medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 16:222-228 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | PURPOSE Medulloblastoma is a highly lethal disease when it recurs. Very few patients survive with conventional treatment. This study evaluated the use of high-dose carboplatin, thiotepa, and etoposide with autologous stem-cell rescue (ASCR) in patients with recurrent medulloblastoma. METHODS Chemotherapy consisted of carboplatin 500 mg/m2 (or area under the curve = 7 mg/mL x min via Calvert formula) on days -8, -7, and -6; and thiotepa 300 mg/m2 and etoposide 250 mg/m2 on days -5, -4, and -3; followed by ASCR on day 0. In addition to the study-prescribed therapy, 21 patients received other treatment: neurosurgical resection in seven, conventional chemotherapy in 17, and external-beam irradiation in 11 cases. RESULTS Twenty-three patients with recurrent medulloblastoma, aged two to 44 years (median, 13 years) at ASCR, were treated. Three patients died of treatment-related toxicities within 21 days of ASCR; multiorgan system failure in two, and Aspergillus infection with venoocclusive disease in one. Seven of 23 patients (30%) are event-free survivors at a median of 54 months post-ASCR (range, 24 to 78 months). Kaplan-Meier estimates of event-free (EFS) and overall survival are 34% +/- 10% and 46% +/- 11%, respectively, at 36 months post-ASCR. CONCLUSION This strategy may provide long-term survival for some patients with recurrent medulloblastoma. |
| Databáze: | OpenAIRE |
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