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Interferon‐beta, MCNU, and conventional radiotherapy for pediatric patients with brainstem glioma
Author(s) -
Ohno Masasuke,
Natsume Atsushi,
Fujii Masazumi,
Ito Motokazu,
Wakabayashi Toshihiko
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21987
Subject(s) - medicine , radiation therapy , glioma , chemotherapy , gastroenterology , temozolomide , neurotoxicity , toxicity , oncology , methyltransferase , methylation , cancer research , biology , dna , genetics
Abstract Background Most children with brainstem glioma die within 2 years of diagnosis, and the median survival time for patients with this condition is less than 1 year. The role of chemotherapy in the treatment of children with brainstem glioma is not well defined. The primary aim of this study is to evaluate the effects of treatment with interferon‐β (IFN‐β), ranimustine (MCNU), and radiotherapy (IMR therapy) administered to brainstem glioma patients treated at our institution. We also determined patient response to IMR therapy by evaluating O 6 ‐methylguanine‐DNA methyltransferase (MGMT) promoter methylation in serum DNA. Procedures We retrospectively reviewed 15 patients who were newly diagnosed to have brainstem tumors and were administered IFN‐β (1–2 MIU/day, days 1–7; 0.5–1 MIU/day, days 8–14) and MCNU (80 mg/m 2 on day 2) concurrently with conventional radiotherapy. Responses were assessed by MRI scan, and data on clinical course and toxicity were obtained from the medical records. The MGMT promoter methylation in serum DNA of five patients was assayed by methylation‐specific PCR. Results Of the 15 patients, partial response, stable disease, and progressive disease were noted in 5 patients each. The median overall survival time and the median progression‐free survival time were 14.7 and 4.6 months, respectively. The protocol was not terminated in any of the patients because of hematological toxicity, nephrotoxicity, or neurotoxicity. The MGMT promoter methylation status in the serum appeared to correlate with a positive response to IMR therapy. Conclusions The IMR combination therapy is well tolerated and may be a promising treatment for brainstem glioma. Pediatr Blood Cancer 2009;53:37–41. © 2009 Wiley‐Liss, Inc.