Reduced incidence of the somnolence syndrome in leukemic children with steroid coverage during prophylactic cranial radiation therapy: Results of a pilot study Journal Article
| Authors: | Mandell, L. R.; Walker, R. W.; Steinherz, P.; Fuks, Z. |
| Article Title: | Reduced incidence of the somnolence syndrome in leukemic children with steroid coverage during prophylactic cranial radiation therapy: Results of a pilot study |
| Abstract: | Chemotherapeutic regimens for childhood acute lymphoblastic leukemia (ALL) include a remission induction period with high, daily doses of prednisone among other agents. A period of central nervous system (CNS) prophylaxis follows, during which steroids are often tapered entirely before cranial radiation (CRT) is completed or even initiated. The somnolence syndrome (SS) has been described 4 to 6 weeks after completion of CRT in up to 60% of the children with doses as low as 1800 cGy. A pilot study of continuous steroid coverage during CRT in childhood ALL was conducted. From July 1984 to July 1986, 38 children entered on Children' Cancer Study Group ALL protocols received CRT of 1800 cGy (180 cGy × 10). All patients received oral prednisone throughout the entire course of CRT at daily doses varying from 3.0 to 60.0 mg/m2. The overall incidence of the SS was 13% (five patients). The development of the syndrome was steroid dose‐dependent: ⩾ mg/m2/d (one of 32 patients), 3% incidence; < 15 mg/m2 (four of six patients), 67% incidence. The presence of headache during CRT was also steroid dose‐related: > ⩾ mg/m2, one of 32 patients; < 15 mg/m2, six of six patients. Of the seven patients with headache during CRT, five developed the SS. The two patients (both of the < 15 mg/m2 group) who did not develop the SS were the only cases treated with increased steroid doses at the onset of headache symptoms. Steroid coverage at a dose of ⩾ mg/m2 during CRT appears to significantly reduce the incidence of acute radiation reactions and the SS. A prospective randomized study is planned to confirm these initial findings. Copyright © 1989 American Cancer Society |
| Keywords: | adolescent; child; clinical article; child, preschool; prednisone; brain radiation; brain neoplasms; radiotherapy dosage; infant; pilot projects; syndrome; headache; somnolence; childhood leukemia; oral drug administration; sleep disorders; leukemia, lymphocytic, acute; disorders of excessive somnolence; prognosis; human; male; female; priority journal |
| Journal Title: | Cancer |
| Volume: | 63 |
| Issue: | 10 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 1989-05-16 |
| Start Page: | 1975 |
| End Page: | 1978 |
| Language: | English |
| DOI: | 10.1002/1097-0142(19890515)63:10<1975::Aid-cncr2820631017>3.0.Co;2-i |
| PUBMED: | 2649222 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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