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Title: Cranial radiation necessary for CNS prophylaxis in pediatric NHL

Abstract

The records of 95 consecutive children less than or equal to 21 years of age with previously untreated diffuse histology NHL registered in our protocols from 1978 to 1983 were reviewed. Seventy-nine patients were considered eligible for analysis. The histologic subtypes represented included lymphoblastic (LB) 37%; histiocytic (DHL) 29%; undifferentiated (DU) 19%; poorly differentiated (DPDL) 9%; and unclassified (UNHL) 6%. Distribution of the patients according to stage showed Stage I, 0%; Stage II, 11%; Stage III, 53%; Stage IV, 36%. Four different Memorial Hospital protocols for systemic chemotherapy were used (LSA2L2 73%; L10 9%; L17 10%; L17M 8%); however, the IT (intrathecal) chemotherapy was uniform (Methotrexate: 6.0-6.25 mg/M2 per treatment course) and was included in the induction, consolidation, and maintenance phases of all treatment protocols. Cranial radiation was included in the induction, consolidation, and maintenance phases of all treatment protocols. Cranial radiation was not included in the CNS prophylaxis program. The overall median time of follow-up was 43 months. The overall CNS relapse rate was 6.3%; however, the incidence of CNS lymphoma presenting as the first isolated site of relapse in patients in otherwise complete remission (minimum follow-up of 19 months with 97% of patients off treatment) was only 1/58more » (1.7%). Our data suggest that IT chemotherapy when given in combination with modern aggressive systemic combination chemotherapy, and without cranial radiation appears to be a highly effective modality for CNS prophylaxis regardless of stage, histology, or bone marrow or mediastinal involvement. (Abstract Truncated)« less

Authors:
; ;
Publication Date:
Research Org.:
Memorial Sloan-Kettering Cancer Center, New York, NY
OSTI Identifier:
6788827
Resource Type:
Journal Article
Journal Name:
Int. J. Radiat. Oncol., Biol. Phys.; (United States)
Additional Journal Information:
Journal Volume: 3
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CENTRAL NERVOUS SYSTEM; LYMPHOMAS; COMBINED THERAPY; BRAIN; CHILDREN; CLASSIFICATION; HISTOLOGY; METHOTREXATE; PATIENTS; AGE GROUPS; ANTIMETABOLITES; BODY; DISEASES; DRUGS; NEOPLASMS; NERVOUS SYSTEM; ORGANS; THERAPY; 550603* - Medicine- External Radiation in Therapy- (1980-); 550600 - Medicine

Citation Formats

Mandell, L R, Wollner, N, and Fuks, Z. Cranial radiation necessary for CNS prophylaxis in pediatric NHL. United States: N. p., 1987. Web. doi:10.1016/0360-3016(87)90009-5.
Mandell, L R, Wollner, N, & Fuks, Z. Cranial radiation necessary for CNS prophylaxis in pediatric NHL. United States. https://doi.org/10.1016/0360-3016(87)90009-5
Mandell, L R, Wollner, N, and Fuks, Z. 1987. "Cranial radiation necessary for CNS prophylaxis in pediatric NHL". United States. https://doi.org/10.1016/0360-3016(87)90009-5.
@article{osti_6788827,
title = {Cranial radiation necessary for CNS prophylaxis in pediatric NHL},
author = {Mandell, L R and Wollner, N and Fuks, Z},
abstractNote = {The records of 95 consecutive children less than or equal to 21 years of age with previously untreated diffuse histology NHL registered in our protocols from 1978 to 1983 were reviewed. Seventy-nine patients were considered eligible for analysis. The histologic subtypes represented included lymphoblastic (LB) 37%; histiocytic (DHL) 29%; undifferentiated (DU) 19%; poorly differentiated (DPDL) 9%; and unclassified (UNHL) 6%. Distribution of the patients according to stage showed Stage I, 0%; Stage II, 11%; Stage III, 53%; Stage IV, 36%. Four different Memorial Hospital protocols for systemic chemotherapy were used (LSA2L2 73%; L10 9%; L17 10%; L17M 8%); however, the IT (intrathecal) chemotherapy was uniform (Methotrexate: 6.0-6.25 mg/M2 per treatment course) and was included in the induction, consolidation, and maintenance phases of all treatment protocols. Cranial radiation was included in the induction, consolidation, and maintenance phases of all treatment protocols. Cranial radiation was not included in the CNS prophylaxis program. The overall median time of follow-up was 43 months. The overall CNS relapse rate was 6.3%; however, the incidence of CNS lymphoma presenting as the first isolated site of relapse in patients in otherwise complete remission (minimum follow-up of 19 months with 97% of patients off treatment) was only 1/58 (1.7%). Our data suggest that IT chemotherapy when given in combination with modern aggressive systemic combination chemotherapy, and without cranial radiation appears to be a highly effective modality for CNS prophylaxis regardless of stage, histology, or bone marrow or mediastinal involvement. (Abstract Truncated)},
doi = {10.1016/0360-3016(87)90009-5},
url = {https://www.osti.gov/biblio/6788827}, journal = {Int. J. Radiat. Oncol., Biol. Phys.; (United States)},
number = ,
volume = 3,
place = {United States},
year = {Sun Mar 01 00:00:00 EST 1987},
month = {Sun Mar 01 00:00:00 EST 1987}
}