Primary chemotherapy for intracranial nongerminomatous germ cell tumors: Results of the second international CNS germ cell study group protocol Journal Article
| Authors: | Kellie, S. J.; Boyce, H.; Dunkel, I. J.; Diez, B.; Rosenblum, M.; Brualdi, L.; Finlay, J. L. |
| Article Title: | Primary chemotherapy for intracranial nongerminomatous germ cell tumors: Results of the second international CNS germ cell study group protocol |
| Abstract: | Purpose: The optimum therapy for intracranial nongerminomatous germ cell tumors (NGGCT) remains controversial. The primary objective of this study was to determine whether intensive cisplatin and cyclophosphamide-based combination chemotherapy was effective in patients with intracranial NGGCT. Patients and Methods: Twenty patients were enrolled, aged 5 to 41 years (median, 13 years). Initial therapy included two courses of Regimen A (cisplatin, etoposide, cyclophosphamide, and bleomycin). Patients achieving a complete remission (CR) then received two courses of Regimen B (carboplatin, etoposide, and bleomycin). Those in CR after four courses of treatment received one additional course of Regimen A and Regimen B, while those not in CR after four treatment courses underwent second-look surgery and/or irradiation. Results: Sixteen of 17 patients assessable for response after two courses of treatment achieved a CR or partial response (CR + partial response, 0.94; 95% Cl, 0.73 to 1.0). With a median follow-up of 6.3 years, 14 of 20 patients are alive without disease; eight patients were without relapse or progression, of whom three received local irradiation in first complete remission in violation of protocol, and six patients were in durable second or third complete remission after further chemotherapy and/or irradiation. The 5-year overall survival and event-free survival were 0.75 (95% Cl, 0.56 to 0.94) and 0.36 (95% Cl, 0.13 to 0.59), respectively. Conclusion: Intensive chemotherapy was effective in one-third of patients in this study. Salvage therapy, including irradiation, was feasible in patients with recurrent disease. © 2004 by American Society of Clinical Oncology. |
| Keywords: | survival; adolescent; adult; cancer chemotherapy; cancer survival; child; clinical article; controlled study; preschool child; treatment outcome; child, preschool; disease-free survival; middle aged; survival analysis; cancer surgery; mortality; salvage therapy; cisplatin; cancer growth; dose response; cancer radiotherapy; comparative study; disease free survival; follow up; antineoplastic agent; prospective study; prospective studies; carboplatin; cohort studies; etoposide; antineoplastic combined chemotherapy protocols; drug administration schedule; cohort analysis; cyclophosphamide; pathology; dose-response relationship, drug; central nervous system tumor; risk assessment; central nervous system neoplasms; confidence interval; confidence intervals; cancer regression; statistical analysis; probability; bleomycin; cancer relapse; drug administration; germ cell tumor; infusions, intravenous; statistics, nonparametric; intravenous drug administration; international cooperation; intracranial tumor; nonparametric test; germinoma; humans; prognosis; human; male; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 22 |
| Issue: | 5 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2004-03-01 |
| Start Page: | 846 |
| End Page: | 853 |
| Language: | English |
| DOI: | 10.1200/jco.2004.07.006 |
| PROVIDER: | scopus |
| PUBMED: | 14990640 |
| DOI/URL: | |
| Notes: | J. Clin. Oncol. -- Cited By (since 1996):42 -- Export Date: 16 June 2014 -- CODEN: JCOND -- Source: Scopus |
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