Abstract
Childhood malignant gliomas are rare, but their clinical behavior is almost as aggressive as in adults, with resistance to therapy, rapid progression, and not uncommonly, dissemination. Our study protocol incorporated sequential chemotherapy and high-dose thiotepa in the preradiant phase, followed by focal radiotherapy and maintenance with vincristine and lomustine for a total duration of one year. The induction treatment consisted of two courses of cisplatin (30 mg/m2) plus etoposide (150 mg/m2) × 3 days and of vincristine (1.4 mg/m2) plus cyclophosphamide (1.5 g/m2) plus high-dose methotrexate (8 g/m2), followed by high-dose thiotepa (300 mg/m2 × 3 doses), with harvesting of peripheral blood progenitor cells after the first cisplatin/etoposide course. From August 1996 to March 2003, 21 children, 14 females and 7 males, with a median age of 10 years were enrolled, 18 presenting with residual disease after surgery. Histologies were glioblastoma multiforme in 10, anaplastic astrocytoma in nine, and anaplastic oligodendroglioma in two; sites of origin were supratentorial areas in 17, spine in two, and posterior fossa in two. Of the 21 patients, 12 have died (10 after relapse, with a median time to progression for the whole series of 14 months; one with intratumoral bleeding at 40 months after diagnosis; and one affected by Turcot syndrome for duodenal cancer relapse). Four of 12 relapsed children had tumor dissemination. At a median follow-up of 57 months, overall survival and progression-free survival at four years were 43% and 46%, respectively. Sequential and high-dose chemotherapy can be afforded in front-line therapy of childhood malignant glioma without excessive morbidity and rather encouraging results.
| Original language | English |
|---|---|
| Pages (from-to) | 41-48 |
| Number of pages | 8 |
| Journal | Neuro-Oncology |
| Volume | 7 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2005 |
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ASJC Scopus subject areas
- Cancer Research
- Oncology
- Clinical Neurology
Cite this
Sequential chemotherapy, high-dose thiotepa, circulating progenitor cell rescue, and radiotherapy for childhood high-grade glioma. / Massimino, Maura; Gandola, Lorenza; Luksch, Roberto; Spreafico, Filippo; Riva, Daria; Solero, Carlo; Giangaspero, Felice; Locatelli, Franco; Podda, Marta; Bozzi, Fabio; Pignoli, Emanuele; Collini, Paola; Cefalo, Graziella; Zecca, Marco; Casanova, Michela; Ferrari, Andrea; Terenziani, Monica; Meazza, Cristina; Polastri, Daniela; Scaramuzza, Davide; Ravagnani, Fernando; Fossati-Bellani, Franca.
In: Neuro-Oncology, Vol. 7, No. 1, 01.2005, p. 41-48.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Sequential chemotherapy, high-dose thiotepa, circulating progenitor cell rescue, and radiotherapy for childhood high-grade glioma
AU - Massimino, Maura
AU - Gandola, Lorenza
AU - Luksch, Roberto
AU - Spreafico, Filippo
AU - Riva, Daria
AU - Solero, Carlo
AU - Giangaspero, Felice
AU - Locatelli, Franco
AU - Podda, Marta
AU - Bozzi, Fabio
AU - Pignoli, Emanuele
AU - Collini, Paola
AU - Cefalo, Graziella
AU - Zecca, Marco
AU - Casanova, Michela
AU - Ferrari, Andrea
AU - Terenziani, Monica
AU - Meazza, Cristina
AU - Polastri, Daniela
AU - Scaramuzza, Davide
AU - Ravagnani, Fernando
AU - Fossati-Bellani, Franca
PY - 2005/1
Y1 - 2005/1
N2 - Childhood malignant gliomas are rare, but their clinical behavior is almost as aggressive as in adults, with resistance to therapy, rapid progression, and not uncommonly, dissemination. Our study protocol incorporated sequential chemotherapy and high-dose thiotepa in the preradiant phase, followed by focal radiotherapy and maintenance with vincristine and lomustine for a total duration of one year. The induction treatment consisted of two courses of cisplatin (30 mg/m2) plus etoposide (150 mg/m2) × 3 days and of vincristine (1.4 mg/m2) plus cyclophosphamide (1.5 g/m2) plus high-dose methotrexate (8 g/m2), followed by high-dose thiotepa (300 mg/m2 × 3 doses), with harvesting of peripheral blood progenitor cells after the first cisplatin/etoposide course. From August 1996 to March 2003, 21 children, 14 females and 7 males, with a median age of 10 years were enrolled, 18 presenting with residual disease after surgery. Histologies were glioblastoma multiforme in 10, anaplastic astrocytoma in nine, and anaplastic oligodendroglioma in two; sites of origin were supratentorial areas in 17, spine in two, and posterior fossa in two. Of the 21 patients, 12 have died (10 after relapse, with a median time to progression for the whole series of 14 months; one with intratumoral bleeding at 40 months after diagnosis; and one affected by Turcot syndrome for duodenal cancer relapse). Four of 12 relapsed children had tumor dissemination. At a median follow-up of 57 months, overall survival and progression-free survival at four years were 43% and 46%, respectively. Sequential and high-dose chemotherapy can be afforded in front-line therapy of childhood malignant glioma without excessive morbidity and rather encouraging results.
AB - Childhood malignant gliomas are rare, but their clinical behavior is almost as aggressive as in adults, with resistance to therapy, rapid progression, and not uncommonly, dissemination. Our study protocol incorporated sequential chemotherapy and high-dose thiotepa in the preradiant phase, followed by focal radiotherapy and maintenance with vincristine and lomustine for a total duration of one year. The induction treatment consisted of two courses of cisplatin (30 mg/m2) plus etoposide (150 mg/m2) × 3 days and of vincristine (1.4 mg/m2) plus cyclophosphamide (1.5 g/m2) plus high-dose methotrexate (8 g/m2), followed by high-dose thiotepa (300 mg/m2 × 3 doses), with harvesting of peripheral blood progenitor cells after the first cisplatin/etoposide course. From August 1996 to March 2003, 21 children, 14 females and 7 males, with a median age of 10 years were enrolled, 18 presenting with residual disease after surgery. Histologies were glioblastoma multiforme in 10, anaplastic astrocytoma in nine, and anaplastic oligodendroglioma in two; sites of origin were supratentorial areas in 17, spine in two, and posterior fossa in two. Of the 21 patients, 12 have died (10 after relapse, with a median time to progression for the whole series of 14 months; one with intratumoral bleeding at 40 months after diagnosis; and one affected by Turcot syndrome for duodenal cancer relapse). Four of 12 relapsed children had tumor dissemination. At a median follow-up of 57 months, overall survival and progression-free survival at four years were 43% and 46%, respectively. Sequential and high-dose chemotherapy can be afforded in front-line therapy of childhood malignant glioma without excessive morbidity and rather encouraging results.
UR - http://www.scopus.com/inward/record.url?scp=20044383920&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=20044383920&partnerID=8YFLogxK
U2 - 10.1215/S1152851704000304
DO - 10.1215/S1152851704000304
M3 - Article
C2 - 15701281
AN - SCOPUS:20044383920
VL - 7
SP - 41
EP - 48
JO - Neuro-Oncology
JF - Neuro-Oncology
SN - 1522-8517
IS - 1
ER -