Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Urban, C; Benesch, M; Pakisch, B; Lackner, H; Kerbl, R; Schwinger, W; Oberbauer, R.
Synchronous radiochemotherapy in unfavorable brain tumors of children and young adults.
J Neurooncol. 1998; 39(1):71-80
Doi: 10.1023%2FA%3A1005966407408
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- Führende Autor*innen der Med Uni Graz
- Urban Ernst-Christian
- Co-Autor*innen der Med Uni Graz
- Benesch Martin
- Kerbl Reinhold
- Lackner Herwig
- Schwinger Wolfgang
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- Abstract:
- The prognosis of patients with incompletely resected malignant brain tumors is almost fatal. In an attempt to improve the outcome of children and young adults with unfavorable brain tumors an intensive multimodal therapeutic strategy was developed combining simultaneous (hyper)fractionated external beam irradiation and conventional adjuvant chemotherapy after initial surgery. 17 patients aged between 2.10 and 25.11 years were entered into the study. 16/17 patients were treated according to the German/Austrian Pediatric Brain Tumor Study Group multicenter trial HIT '91. They are not protocol patients of this HIT '91 trial. Induction chemotherapy consisted of 2 courses of ifosfamide (3 g/m2/d) on days 1-3, etoposide (150 mg/m2/d) on days 4-6, methotrexate (5 g/m2) on days 15 and 22, cisplatin (40 mg/m2/d) and cytarabine (400 mg/m2/d) on days 29-31. Three weeks after the last dose of cisplatin/cytarabine the second course of chemotherapy was started. The last patient entered into the study received a modified therapy containing ifosfamide, cisplatin and etoposide. Synchronously at a median of 12 days after initiation of chemotherapy 12/17 patients received local radiotherapy (6000-7040 cGy) to the brain and 5/17 patients craniospinal irradiation (3520 cGy with a tumor boost of 1400-2000 cGy). 4-6 weeks after completion of the second course of chemotherapy maintenance therapy was started with carmustine (CCNU) (75 mg/m2) and carboplatin (400 mg/m2) each on day 1 and vincristine (1.5 mg/m2) on day 1, 8, 15. This course was repeated eight times every six weeks. 9/17 patients are alive at a median follow-up of 25 months (range 5-50) with 4 complete remissions, 2 partial remissions and 1 stable disease lasting 42+ months. Two patients, who initially had stable disease, progressed, but are still alive at 31+ and 41+ months after diagnosis. Median progression-free survival and median overall survival is 19 and 36 months, respectively. Hematologic and methotrexate-induced toxicity were severe and resulted in one therapy-related death. However, radiotherapy concomitant to chemotherapy appears to be an effective method of treatment for brain tumors with poor prognosis, though toxicity is severe in some cases.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Antineoplastic Combined Chemotherapy Protocols - adverse effects
- Brain Neoplasms - drug therapy
- Carboplatin - administration and dosage
- Chemotherapy, Adjuvant - administration and dosage
- Child - administration and dosage
- Child, Preschool - administration and dosage
- Cisplatin - administration and dosage
- Combined Modality Therapy - administration and dosage
- Cranial Irradiation - administration and dosage
- Cytarabine - administration and dosage
- Deafness - chemically induced
- Disease Progression - chemically induced
- Disease-Free Survival - chemically induced
- Etoposide - administration and dosage
- Follow-Up Studies - administration and dosage
- Glioma - drug therapy
- Hearing Loss - chemically induced
- Hematologic Diseases - chemically induced
- Humans - chemically induced
- Ifosfamide - administration and dosage
- Infection - etiology
- Life Tables - etiology
- Liver Diseases - chemically induced
- Lomustine - administration and dosage
- Medulloblastoma - drug therapy
- Methotrexate - administration and dosage
- Prognosis - administration and dosage
- Radiotherapy, Adjuvant - administration and dosage
- Remission Induction - administration and dosage
- Vincristine - administration and dosage
- Find related publications in this database (Keywords)
- Synchronous Radiochemotherapy
- Children and Young Adults
- Unfavorable Brain Tumors
- Incomplete Resection