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Low-dose craniospinal irradiation and ifosfamide, cisplatin and etoposide for non-metastatic embryonal tumors in the central nervous system.
Jpn J Clin Oncol 2008; 38(7):486-92JJ

Abstract

OBJECTIVE

The current study was conducted to evaluate the effects of low-dose craniospinal irradiation (CSI) combined with chemotherapy on non-metastatic embryonal tumors in the central nervous system (CNS), including medulloblastoma and supra-tentorial primitive neuroectodermal tumors (ST-PNET).

METHODS

All patients were treated according to the following protocol. After surgery, the patients < or =5 years old received 18 Gy and the patients >5 years old received 24 Gy CSI. The dose to the primary tumor bed was 39.6-54 Gy. Chemotherapy consisted of ifosfamide, cisplatin and etoposide (ICE chemotherapy).

RESULTS

Sixteen patients aged 0.5-20.4 (median 6.1) years were enrolled and followed for 11-165 (median 112) months. Both 5-year actuarial overall survival (OAS) and progression-free survival (PFS) were 81% (95% confidence interval (CI): 62-100%) for the 16 patients. Both 5-year OAS and PFS were 82% (CI: 59-100%) for the patients with medulloblastoma and 80% (CI: 45-100%) for the patients with ST-PNET. Both 5-year OAS and PFS were 75% for the eight patients < or =5 years old and 88% for the eight patients >5 years old. Both 5-year OAS and PFS were 100% for six average-risk patients (3 years or older, total resection and posterior fossa) and 70% for 10 poor-risk patients (others). The median total intellectual quotient at the last follow-up was 85 (ranging from 48 to 103) in 12 patients who were followed for 3-145 (median 49) months. Eight patients received hormone replacement therapy.

CONCLUSION

Low-dose CSI and ICE chemotherapy may have a role as a treatment option for a subset of patients with non-metastatic embryonal tumors in the CNS.

Authors+Show Affiliations

Hokkaido University School of Medicine, North-15 West-7, Kita-ku, Sapporo, Japan. kyasuda@radi.med.hokudai.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18573848

Citation

Yasuda, Koichi, et al. "Low-dose Craniospinal Irradiation and Ifosfamide, Cisplatin and Etoposide for Non-metastatic Embryonal Tumors in the Central Nervous System." Japanese Journal of Clinical Oncology, vol. 38, no. 7, 2008, pp. 486-92.
Yasuda K, Taguchi H, Sawamura Y, et al. Low-dose craniospinal irradiation and ifosfamide, cisplatin and etoposide for non-metastatic embryonal tumors in the central nervous system. Jpn J Clin Oncol. 2008;38(7):486-92.
Yasuda, K., Taguchi, H., Sawamura, Y., Ikeda, J., Aoyama, H., Fujieda, K., ... Shirato, H. (2008). Low-dose craniospinal irradiation and ifosfamide, cisplatin and etoposide for non-metastatic embryonal tumors in the central nervous system. Japanese Journal of Clinical Oncology, 38(7), pp. 486-92. doi:10.1093/jjco/hyn049.
Yasuda K, et al. Low-dose Craniospinal Irradiation and Ifosfamide, Cisplatin and Etoposide for Non-metastatic Embryonal Tumors in the Central Nervous System. Jpn J Clin Oncol. 2008;38(7):486-92. PubMed PMID: 18573848.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low-dose craniospinal irradiation and ifosfamide, cisplatin and etoposide for non-metastatic embryonal tumors in the central nervous system. AU - Yasuda,Koichi, AU - Taguchi,Hiroshi, AU - Sawamura,Yutaka, AU - Ikeda,Jun, AU - Aoyama,Hidefumi, AU - Fujieda,Kenji, AU - Ishii,Nobuaki, AU - Kashiwamura,Masaaki, AU - Iwasaki,Yoshinobu, AU - Shirato,Hiroki, Y1 - 2008/06/23/ PY - 2008/6/25/pubmed PY - 2008/9/16/medline PY - 2008/6/25/entrez SP - 486 EP - 92 JF - Japanese journal of clinical oncology JO - Jpn. J. Clin. Oncol. VL - 38 IS - 7 N2 - OBJECTIVE: The current study was conducted to evaluate the effects of low-dose craniospinal irradiation (CSI) combined with chemotherapy on non-metastatic embryonal tumors in the central nervous system (CNS), including medulloblastoma and supra-tentorial primitive neuroectodermal tumors (ST-PNET). METHODS: All patients were treated according to the following protocol. After surgery, the patients < or =5 years old received 18 Gy and the patients >5 years old received 24 Gy CSI. The dose to the primary tumor bed was 39.6-54 Gy. Chemotherapy consisted of ifosfamide, cisplatin and etoposide (ICE chemotherapy). RESULTS: Sixteen patients aged 0.5-20.4 (median 6.1) years were enrolled and followed for 11-165 (median 112) months. Both 5-year actuarial overall survival (OAS) and progression-free survival (PFS) were 81% (95% confidence interval (CI): 62-100%) for the 16 patients. Both 5-year OAS and PFS were 82% (CI: 59-100%) for the patients with medulloblastoma and 80% (CI: 45-100%) for the patients with ST-PNET. Both 5-year OAS and PFS were 75% for the eight patients < or =5 years old and 88% for the eight patients >5 years old. Both 5-year OAS and PFS were 100% for six average-risk patients (3 years or older, total resection and posterior fossa) and 70% for 10 poor-risk patients (others). The median total intellectual quotient at the last follow-up was 85 (ranging from 48 to 103) in 12 patients who were followed for 3-145 (median 49) months. Eight patients received hormone replacement therapy. CONCLUSION: Low-dose CSI and ICE chemotherapy may have a role as a treatment option for a subset of patients with non-metastatic embryonal tumors in the CNS. SN - 1465-3621 UR - https://www.unboundmedicine.com/medline/citation/18573848/Low_dose_craniospinal_irradiation_and_ifosfamide_cisplatin_and_etoposide_for_non_metastatic_embryonal_tumors_in_the_central_nervous_system_ L2 - https://academic.oup.com/jjco/article-lookup/doi/10.1093/jjco/hyn049 DB - PRIME DP - Unbound Medicine ER -