Intensive chemotherapy and bone marrow rescue for young children with newly diagnosed malignant brain tumors.

• DOI: 10.1200/jco.1998.16.1.210
• Publication Date: 2017-02-24T10:06:55Z
• Authors: W P Mason; A Grovas; S Halpern; I J Dunkel; J Garvin; G Heller; M Rosenblum; S Gardner; D Lyden; S Sands; D Puccetti; K Lindsley; T E Merchant; B O'Malley; L Bayer; M M Petriccione; J Allen; J L Finlay
• Keywords: Induction chemotherapy; Carboplatin; ThioTEPA

PURPOSE To evaluate a strategy that avoids radiotherapy in children less than 6 years of age with newly diagnosed malignant brain tumors, by administering myeloablative consolidation chemotherapy autologous bone marrow reconstitution (ABMR) after maximal surgical resection and conventional induction chemotherapy. PATIENTS AND METHODS Between March 1991 April 1995, 62 (median age, 30 months) tumors were enrolled onto this trial. Children received vincristine, cisplatin, cyclophosphamide, etoposide, repeated every 3 weeks for five cycles. without disease progression on offered incorporated carboplatin, thiotepa, etoposide followed ABMR. Irradiation was used only residual tumor at or progressive/recurrent disease. RESULTS Induction well tolerated most patients; however, noted 17 (27%) four (6%) died treatment complications. Of 37 who ABMR, 15 are free post-ABMR further treatment, >44 months). The remaining 22 all progressed within months ABMR; three (8%) treatment-related 3-year overall survival (OS) event-free (EFS) rates from diagnosis 40% (95% confidence interval [CI], 28% to 52%) 25% CI, 13% 37%), respectively. Radiotherapy administered 19 children: progressive (PD) two the time CONCLUSION A significant proportion can avoid prolonged maintenance yet still achieve durable remission brief intensive regimen.