Evaluation of response to postradiation eight in one chemotherapy in childhood brain tumors |
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Authors: | Inci Ayan Emin Darendeliler Rejin Kebudi Orhan Barlas Nihat Ayan Çiçek Bayindir Sara Bahar Nijad Bilge |
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Affiliation: | (1) Department of Pediatric Oncology, The University of Istanbul, Turkey;(2) Department of Radiation Oncology, Institute of Oncology, The University of Istanbul, Turkey;(3) Department of Neurosurgery, School of Medicine, The University of Istanbul, Turkey;(4) Department of Neuropathology, School of Medicine, The University of Istanbul, Turkey;(5) Department of Neuroradiology, School of Medicine, The University of Istanbul, Turkey;(6) Department of Otorhinolaryngology, Beyoglu Hospital, Istanbul, Turkey |
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Abstract: | Ten children, 3 to 15 years of age with high risk primary brain tumors were treated with postradiation eight in one chemotherapy; vincristine, lomustine, procarbazine, hydroxyurea, cisplatin, cytosine arabinoside, cyclophosphamide and methylprednisolone. The tumors comprised of three medulloblastomas, two primitive neuroectodermal tumors, one ependymoblastoma and four anaplastic ependymomas. Treatment involved surgery (two total resection, six subtotal and two biopsy only) followed by conventional radiotherapy (primary tumor: 50–54 Gy, whole brain: 30–45 Gy, and spinal axis: 25–36 Gy). Objective tumor response with radiotherapy was achieved in 7 of 9 patients (78%) (6/8 patients with residual tumor and one patient with complete resection but positive cerebrospinal fluid cytology). Complete response was attained in 4 of 9 patients (44%). Eight in one chemotherapy was initiated four weeks after radiation and repeated at 4 weekly intervals for 5–8 courses. Postradiation eight in one failed to show any additional effect on tumor responses. Median survival was 34 months (range 9–48 months) with five of ten patients alive: four in complete and one in partial remission. All the five survivors were among the patients who had achieved response to initial treatment. This result suggested that degree of response to initial treatment might determine subsequent outcome and thus the choice of modality for initial therapy might be important. |
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Keywords: | childhood brain tumors /content/r8501j0w77206463/xxlarge8216.gif" alt=" lsquo" align=" BASELINE" BORDER=" 0" >eight in one /content/r8501j0w77206463/xxlarge8217.gif" alt=" rsquo" align=" BASELINE" BORDER=" 0" > radiotherapy chemotherapy |
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