Multimodality therapy for medulloblastoma. [Efficacy and complications]

Journal Article · Fri Feb 15 04:00:00 EST 1980 · Cancer; (United States)

OSTI ID:5519023

Thomas, P R.M. ^[1]; Duffner, P K; Cohen, M E; Sinks, L F; Tebbi, C; Freeman, A I

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1. Roswell Park Memorial Inst., Buffalo, NY

Eight patients with recurrent medulloblastoma were treated with a chemotherapy regimen consisting of vincristine, BCNU, dexamethasone and intrathecal and intermediate dose intravenous methotrexate (500 mg/m/sup 2/). Five also received local low dose radiotherapy (RT). All 8 patients responded to treatment; 6 completely and 2 partially. These latter 2 were in their second and third recurrences. Three remain in remission. The median duration of response was 18.8 months, and median time from start of chemotherapy to death was 32 months using the Kaplan-Meier technique. In addition, 9 other patients with newly diagnosed medulloblastoma were treated with craniospinal radiation and the same adjuvant chemotherapy as above. The first 5 patients also received intraventricular methotrexate and/or intravenous BCNU during radiotherapy. The toxicity in the 5 patients was very severe. There were three toxic deaths, one death from cancer; one patient survives disease-free, but he is demented. With the discontinuance of intraventricular methotrexate and the postponement of myelosuppressive chemotherapy until after the completion of radiotherapy, the regimen has been well tolerated. All 4 patients treated this way remain alive, well, and disease-free at intervals up to 36 months. We conclude that recurrent medulloblastomas are sensitive to multiagent chemotherapy and that prolonged remissions may occur. With primary adjuvant chemotherapy, extreme caution with myelosuppressive drugs must be exercised during the period of craniospinal radiotherapy. We also do not recommend the use of intraventricular methotrexate. When these two criteria were followed, the preliminary results with adjuvant chemotherapy appear encouraging.

• OSTI ID: 5519023
• Journal Information: Cancer; (United States), Journal Name: Cancer; (United States) Vol. 45:4; ISSN CANCA
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANIMALS
BIOLOGICAL EFFECTS
BIOLOGICAL MATERIALS
BIOLOGICAL RADIATION EFFECTS
BLOOD
BLOOD CELLS
BLOOD PLATELETS
BODY
BODY FLUIDS
BRAIN
CENTRAL NERVOUS SYSTEM
CEREBELLUM
CHEMOTHERAPY
CHILDREN
DATA
DATA COMPILATION
DATA FORMS
DELAYED RADIATION EFFECTS
DISEASES
ELECTRONS
ELEMENTARY PARTICLES
ENCEPHALITIS
FERMIONS
FRACTIONATED IRRADIATION
INFORMATION
IRRADIATION
ISOLATED VALUES
LEPTONS
LOCAL IRRADIATION
LOW DOSE IRRADIATION
MAMMALS
MAN
MATERIALS
MEDICINE
NEOPLASMS
NERVOUS SYSTEM
NERVOUS SYSTEM DISEASES
NUCLEAR MEDICINE
NUMERICAL DATA
ORGANS
PATIENTS
PRIMATES
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOSENSITIVITY EFFECTS
RADIOTHERAPY
SIDE EFFECTS
SPINAL CORD
THERAPY
TOXICITY
VERTEBRATES