The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: Results of a randomized trial - A report from the Childrens Cancer Study Group
Richard Sposto,I. J. Ertel,R. D. T. Jenkin,Carl P. Boesel,J. L. Venes,J. A. Ortega,Audrey E. Evans,William M. Wara,Denman Hammond +8 more
TLDR
This study is to the authors' knowledge the only randomized trial to investigate effectiveness of chemotherapy in the treatment of high-grade astrocytoma in children and found that treatment with chemotherapy prolonged survival and event-free survival.Abstract:
Fifty-eight patients with high-grade astrocytoma were treated by members of the Childrens Cancer Study Group in a prospective randomized trial designed to study the effectiveness of chemotherapy as an adjuvant to standard surgical treatment and radiotherapy. Following surgical therapy, patients were assigned randomly to radiotherapy with or without chemotherapy consisting of chloroethyl-cyclohexyl nitrosourea, vincristine, and prednisone. Treatment with chemotherapy prolonged survival and event-free survival. Five-year event-free survival was 46% for patients in the radiotherapy and chemotherapy group, and 18% for patients in the radiotherapy-alone group. Five-year survival was similarly improved. The differences in outcome due to treatment were statistically significant after correcting for imbalances in important prognostic factors (event-free survival, p = 0.026; survival, p = 0.067). The presence of mitoses or necrosis in the tumor specimen was associated with poorer outcome. Patients whose initial surgery was limited to biopsy, and patients with basal ganglia lesions, also had significantly worse outcome. Chemotherapy administered at the time of recurrence in a small number of patients did not produce any long-term survivors. This study is to our knowledge the only randomized trial to investigate effectiveness of chemotherapy in the treatment of high-grade astrocytoma in children.read more
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Postoperative Chemotherapy and Delayed Radiation in Children Less Than Three Years of Age With Malignant Brain Tumors
Patricia K. Duffner,Marc E. Horowitz,Jeffrey P. Krischer,Henry S. Friedman,Peter C. Burger,Michael E. Cohen,Robert A. Sanford,Raymond K. Mulhern,Hector E. James,Carolyn R. Freeman,F. Glen Seidel,Larry E. Kun +11 more
TL;DR: Chemotherapy appears to be an effective primary postoperative treatment for many malignant brain tumors in young children and a comparison of cognitive evaluations obtained at base line and after one year of chemotherapy revealed no evidence of deterioration in cognitive function.
Journal ArticleDOI
Brain Tumors in Children
TL;DR: Although the mortality rate for these neoplasms exceeds the rates for many other childhood tumors, recent therapeutic advances coupled with refinements in neuroimaging techniques, have increased the percentage of affected children who survive to .
Journal ArticleDOI
Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. Childrens Cancer Group
Jonathan L. Finlay,James M. Boyett,Allan J. Yates,Jeffrey H. Wisoff,Jerrold M. Milstein,J R Geyer,Salvatore Bertolone,P McGuire,Joel M. Cherlow,M Tefft +9 more
TL;DR: There is no benefit to the treatment of high-grade astrocytomas in children with eight-drugs-in-1-day chemotherapy compared with CCNU, vincristine, and prednisone, and a difference in toxicity between the two chemotherapeutic regimens.
Journal ArticleDOI
Temozolomide in the treatment of high-grade gliomas in children: a report from the Children's Oncology Group
Kenneth J. Cohen,Ian F. Pollack,Tianni Zhou,Allen Buxton,Emiko J. Holmes,Peter C. Burger,Daniel J. Brat,Marc K. Rosenblum,Ronald L. Hamilton,Robert S. Lavey,Richard L. Heideman +10 more
TL;DR: There was no evidence that temozolomide given during radiation therapy and as adjuvant therapy resulted in improved EFS compared with that found in CCG-945 and MGMT overexpression was adversely associated with survival.
Journal ArticleDOI
Current neurosurgical management and the impact of the extent of resection in the treatment of malignant gliomas of childhood: a report of the Children's Cancer Group Trial No. CCG-945
Jeffrey H. Wisoff,James M. Boyett,Mitchel S. Berger,Catherine Brant,Hao Li,Allan J. Yates,Patricia McGuire-Cullen,Patrick A. Turski,Leslie N. Sutton,Jeffrey C. Allen,Roger J. Packer,Jonathan L. Finlay +11 more
TL;DR: The demonstration of a survival advantage provided by radical resection should prompt neurosurgeons to treat malignant pediatric astrocytomas with aggressive surgical resection prior to initiation of radiotherapy or adjuvant chemotherapy.
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