Chemotherapy of primary malignant brain tumors in children

Shapiro, William R.

doi:10.1002/1097-0142(197503)35:3+<965::aid-cncr2820350718>3.0.co;2-#

Cited by 41 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The clinical value of chemotherapy in medulloblastoma is not yet clear, but responses have been reported in many cases with the use of intrathecal methotrexate, and with BCNU, C C N U and vincristine (SHAPIRO 1975). BLOOM (1975) has supplemented the usual medulloblastoma treatment with intravenous vincristine, oral C C N U and intrathecal methotrexate in a preliminary investigation.…”

Section: Discussionmentioning

confidence: 99%

Medulloblastoma: Treatment Results

Nüchel

Andersen

1978

Acta Radiologica: Oncology, Radiation, Physics, Biology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Medulloblastoma: Treatment Results

Nüchel

Andersen

1978

Acta Radiologica: Oncology, Radiation, Physics, Biology

View full text Add to dashboard Cite

“…It may nevertheless be effective against portions of the tumor in which the blood-brain barrier is disrupted. All have shown the ability to induce tumor responses in one or more intracranial neoplasms [6][7][8][9]. Prednisone was included to minimize undesirable neurological reactions to initiation or withdrawal of drug therapy due to cerebral edema, and for the possibility that its effect on cell membrane permeability might enhance the action of the other chemotherapeutic agents.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: Results of a randomized trial

et al. 1989

View full text Add to dashboard Cite

Fifty-eight patients with high-grade astrocytoma were treated by members of the Childrens Cancer Study Group in a prospective randomized trial designed to study the effectiveness of chemotherapy as an adjuvant to standard surgical treatment and radiotherapy. Following surgical therapy, patients were assigned randomly to radiotherapy with or without chemotherapy consisting of chloroethyl-cyclohexyl nitrosourea, vincristine, and prednisone. Treatment with chemotherapy prolonged survival and event-free survival. Five-year event-free survival was 46% for patients in the radiotherapy and chemotherapy group, and 18% for patients in the radiotherapy-alone group. Five-year survival was similarly improved. The differences in outcome due to treatment were statistically significant after correcting for imbalances in important prognostic factors (event-free survival, p = 0.026; survival, p = 0.067). The presence of mitoses or necrosis in the tumor specimen was associated with poorer outcome. Patients whose initial surgery was limited to biopsy, and patients with basal ganglia lesions, also had significantly worse outcome. Chemotherapy administered at the time of recurrence in a small number of patients did not produce any long-term survivors. This study is to our knowledge the only randomized trial to investigate effectiveness of chemotherapy in the treatment of high-grade astrocytoma in children.

show abstract

“…Response rates to these drugs were determined prior to the availability of high resolution CT scanning. Relatively few phase II pediatric brain tumor trials have been conducted with BCNU and CCNU [6] and the studies have included only small numbers of patients with a variety of tumors. Nevertheless, these drugs have been considered active in a number of pediatric brain tumors such as brainstem glioma, cerebral glioma, and medulloblastoma.…”

Section: Discussionmentioning

confidence: 99%

“…Responses have been reported in 7/23 (30%) patients with brainstem glioma and 3/12 (25%) patients with medulloblastoma [6]. CCNU has been combined with vincristine and prednisone in a randomized phase III trial in newly diagnosed brainstem glioma, malignant cerebral astrocytoma, and medulloblastoma in recently completed studies conducted by the Children's Cancer Study Group [7].…”

Section: Discussionmentioning

confidence: 99%

PCNU and recurrent childhood brain tumors

et al. 1987

View full text Add to dashboard Cite

PCNU, the latest nitrosourea analogue to be subjected to clinical trials, held promise as a superior chemotherapy agent for brain tumors because of more favorable biochemical and cytotoxic characteristics in laboratory studies. Thirty-nine children with a variety of recurrent primary CNS tumors, all of whom had evaluable disease, participated in a phase II PCNU trial. Their mean age was 9.7 (3-20) years. PCNU was administered as a 2 hour intravenous infusion in one of 2 dose schedules at 6-7 week intervals; 100-125 mg/m2 for minimally treated patients and 70-90 mg/m2 for heavily treated patients. Response was assessed after 2 courses of chemotherapy after attempting to taper the steroid dose. The overall objective response rate was 18% (7/39) for a mean of 5.9 months (2+ -12). Only partial responses were observed. Disease-specific responses rates were: brainstem glioma--18% (3/17); cerebral glioma--27% (3/12); ependymoma--1/1; and primitive neuroectodermal tumors--(0/9) including 5 medulloblastomas, 2 pineoblastomas and 3 cerebral primitive neuroectodermal tumors. Toxicity was primarily hematologic and clinically significant thrombocytopenia (less than 50,000 mm3) was encountered in 30/38 (79%) patient trials. Modest activity of PCNU in recurrent childhood gliomas is confirmed. Our response rates, using objective CT criteria, are somewhat lower than those reported for BCNU and CCNU. Because of comparable hematologic toxicity and efficacy, intravenous PCNU does not appear to offer a clinical advantage to existing nitrosoureas for children with recurrent brain tumors using a 2 hour intravenous infusion schedule.

show abstract

Chemotherapy of primary malignant brain tumors in children

Cited by 41 publications

References 29 publications

Medulloblastoma: Treatment Results

Medulloblastoma: Treatment Results

The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: Results of a randomized trial

PCNU and recurrent childhood brain tumors

Contact Info

Product

Resources

About