High-dose carboplatin, thiotepa, and etoposide with autologous stem-cell rescue for patients with recurrent medulloblastoma Journal Article
| Authors: | Dunkel, I. J.; Boyett, J. M.; Yates, A.; Rosenblum, M.; Garvin, J. H. Jr; Bostrom, B. C.; Goldman, S.; Sender, L. S.; Gardner, S. L.; Li, H.; Allen, J. C.; Finlay, J. L.; for the Children's Cancer Group |
| Article Title: | High-dose carboplatin, thiotepa, and etoposide with autologous stem-cell rescue for patients with recurrent medulloblastoma |
| Abstract: | 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 · 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 73 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. |
| Keywords: | adolescent; adult; cancer survival; child; clinical article; child, preschool; survival analysis; cancer recurrence; multimodality cancer therapy; combined modality therapy; carboplatin; neoplasm recurrence, local; etoposide; antineoplastic combined chemotherapy protocols; stem cell transplantation; hematopoietic stem cell transplantation; thiotepa; infant; medulloblastoma; pancytopenia; cerebellar neoplasms; transplantation, autologous; aspergillosis; bone marrow rescue; multiple organ failure; vein occlusion; beam therapy; humans; human; male; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 16 |
| Issue: | 1 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1998-01-01 |
| Start Page: | 222 |
| End Page: | 228 |
| Language: | English |
| PUBMED: | 9440746 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 12 December 2016 -- Source: Scopus |
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