Treatment > Vincristine

Meeting Abstract

Treatment of children with meduloblastoma (MBT) older than 36 month with adjusted dose of hyperfractionated radiotherapy (HRT) and VCR-CCNU-CDDP

Daniel H Alderete, Marcela Paladino, Rodolfo Verna, Elsa Raslawski, Federico Sackmann-Muriel

Hospital de Pediatria J P Garrahan, Buenos Aires, Argentina

Material and Methods. Between June 1991 and August 2000, 121 consecutive pts were diagnosed.
Seven pts died immediately after surgery.
Pts were considered standard risk (SR): stage M0; and high risk (HR): stage M1-3 based on MRI and CFS cytologic analysis.
All pts received HRT and weekly doses of vincristine (VCR) after surgery.
HRT dose was 6000 cGy in Posterior Fossa and Craniospinal dose was tailored according to Chang stage 2600-3000-3600 cGy plus boost in metastases for stage M0, M1, M2-3, respectively.
After completion of HRT, all pts received 8 cycles of Cisplatin 75 mg/m2/d1, CCNU 75 mg/m2/d1 and VCR 1,5 mg/m2/d1-8-15, given every 6 weeks (Philadelphia protocol).
Seventy-one pts were SR MBT, 57 were evaluated, the median age: 84 (36-217)m, male: 31/female: 26.
Forty-three pts were HR MBT, 26 were evaluated and a median age of 79(39-216)m, Male: 16/female:10.
Nine pts were stage M1 and 17 pts were stage M2-3.

Results. Pts of SR with a median follow-up of 52 (8-122)m, had 18 events: 15 relapses at a median time from diagnosis of 18 (8-96)m, 2 pts had a second tumor: undifferentiated sarcoma supratentorial (74m) and a diffuse brainstem tumor no biopsed (108m); and 1 pt died without disease (8m).
Five years event free survival (EFS) is 69,5% and the overall survival (OS) 72,1%.
Pts of HR with a median follow up of 35(4-104)m, had 14 events: 11 relapses at a median time from diagnosis of 13 (2-56)m, and 3 pts died in remission.
Five years EFS and OS was 44,4% and 59.4% respectively.

Conclusions. The results of pts of SR group were encouraging considering the reduced dose of craniospinal HRT used.
The outcome achieved in the high risk group, reproduce results of other more intensive protocol.

© Copyright 2002 American Society of Clinical Oncology