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Adjuvant chemotherapy for the treatment of intracranial ependymoma of childhood
Author(s) -
Needle Michael N.,
Goldwein Joel W.,
Grass Jeffrey,
Cnaan Avital,
Bergman Ira,
Molloy Patricia,
Sutton Leslie,
Zhao Huaqing,
Garvin James H.,
Phillips Peter C.
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970715)80:2<341::aid-cncr23>3.0.co;2-t
Subject(s) - medicine , ependymoma , chemotherapy , vincristine , carboplatin , surgery , etoposide , radiation therapy , cisplatin , cyclophosphamide
BACKGROUND Current treatment for childhood intracranial ependymomas with surgery and radiation therapy (RT) yields 5‐year survival rates ranging from 50‐70% after complete resection to 0‐30% after incomplete surgical resection. The role of chemotherapy in the treatment of ependymoma has not been established. In this pilot study, children with newly diagnosed intracranial ependymoma were treated with RT and chemotherapy using agents comparable to those found to be active in the treatment of intracranial ependymoma in infants. METHODS Nineteen children age 3‐14 years (median, 7.5 years) were treated with postoperative RT and chemotherapy. Chemotherapy was comprised of carboplatin, 560 mg/m 2 , with vincristine, 1.5 mg/m 2 , weekly for 3 weeks, alternating at 4‐week intervals with ifosfamide, 1.8 g/m 2 , and etoposide, 100 mg/m 2 , for 5 consecutive days for a total of 4 cycles. RESULTS The 5‐year progression free survival (PFS) estimate was 74%. The extent of surgical resection was not a significant prognostic factor in this study. By contrast, ependymomas located in the posterior fossa were associated with a higher rate of progression ( P = 0.036). Toxicity, limited predominantly to myelosuppression, was manageable. CONCLUSIONS The PFS for children with postoperative residual ependymoma treated with RT and chemotherapy in this study was higher than published survival results for RT alone. These results suggest a role for multialkylator chemotherapy in incompletely resected intracranial ependymoma and provide the rationale for a randomized trial comparing this strategy with conventional postoperative RT. Cancer 1997; 80:341‐7. © 1997 American Cancer Society.