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Prevention of central nervous system leukemia by irradiation
Author(s) -
Hustu H. O.,
Aur R. J. A.,
Verzosa M. S.,
Simone J. V.,
Pinkel D.
Publication year - 1973
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197309)32:3<585::aid-cncr2820320311>3.0.co;2-k
Subject(s) - medicine , methotrexate , prophylactic cranial irradiation , leukemia , central nervous system , complete remission , acute lymphocytic leukemia , radiation therapy , chemotherapy , surgery , oncology , lymphoblastic leukemia , myocardial infarction , conventional pci
During the past 10 years, 1962 to 1972, we have administered irradiation to the central nervous system (CNS) during the first few weeks of remission of acute lymphocytic leukemia (ALL) as an integral part of a treatment plan aimed at cure of ALL. Its purpose has been to eradicate residual leukemia in the CNS and thus prevent CNS relapse. The results indicate that craniospinal irradiation alone, 2400 rads, or cranial irradiation, 2400 rads, with simultaneous intrathecal methotrexate is effective in ‐preventing CNS relapse. This results in marked improvement in complete remission duration and a 50% frequency of long‐term leukemia‐free survival and possible cure. Although intermittent intrathecal methotrexate during remission is said to reduce the incidence of CNS relapse by one half, a 15‐fold reduction results from adequate preventive CNS irradiation. Until a better method is found, all children with ALL should receive adequate CNS irradiation early during remission in order to prevent CNS relapse and to prolong complete remission.