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Title:
Radiotherapy with concurrent and adjuvant temozolomide in children with newly diagnosed diffuse intrinsic pontine glioma | Journal of Neuro-Oncology
Description:
The purpose of this study is to evaluate the efficacy and toxicity of radiation therapy (RT) with concurrent temozolomide (TMZ) chemotherapy followed by adjuvant TMZ in children with diffuse intrinsic pontine glioma (DIPG). Newly diagnosed patients younger than 18 years with histologically proven DIPG were treated with focal radiotherapy to a dose of 54 Gy in 30 fractions along with concurrent daily TMZ (75 mg/m2/day). Four weeks after completing the initial RTâTMZ schedule, adjuvant TMZ (200 mg/m2/day, days 1â5) was given every 28 days up to six cycles. Responses/progressions were assessed by clinical and 2-monthly MRI follow-up studies. Between September 2005 and September 2009, 21 patients with newly diagnosed histologically confirmed DIPG were eligible for this study. Median age at diagnosis was 6.4 years (range 4â16 years). At last update in August 2010, 17 children have died, 1 child was alive with progressive disease and 3 with stable disease. Metastatic relapse was documented in the cerebral site in two patients and in spinal cord in two cases. The median time to progression was 7.5 months (range 28 daysâ14.5 months) and the median survival was 11.7 months (range 26 daysâ17.5 months). The 1-year PFS and the 1-year OS were 33 and 50%, respectively. Five patients presented radiological findings compatible with pseudoprogression during the treatment. Haematological toxicity (Grade III/IV thrombocytopenia and leucopenia) was the most commonly found and led to dose reductions of TMZ in 58% of the patients. TMZ with radiation therapy has not yielded any significant improvement in outcome of children with DIPG and is associated with higher toxicity compared with radiotherapy alone. Novel treatment modalities are needed to improve the outcome of these patients.
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article, google, scholar, pubmed, children, cas, diffuse, gliomas, radiotherapy, pontine, study, cancer, temozolomide, glioma, oncol, newly, diagnosed, intrinsic, radiation, brain, treatment, oncology, stem, hyperfractionated, group, therapy, patients, pediatric, brainstem, adjuvant, int, radiat, biol, phys, phase, tmz, department, france, privacy, cookies, content, journal, concurrent, access, trial, results, iii, publish, search, clinical,
Topics {âď¸}
month download article/chapter grade iii/iv thrombocytopenia diffuse pontine glioma diffuse brainstem glioma pediatric oncology group pediatric pontine gliomas high-grade malignant gliomas brain-stem glioma diffuse pontine gliomas diffuse brainstem gliomas paediatric oncology brain stem gliomas diffuse pontine lesions brain stem tumors initial rtâtmz schedule full article pdf related subjects privacy choices/manage cookies neuro-oncology aims brazilian cooperative study phase ii study hyperfractionated radiation therapy christelle dufour oncology group prospective observational study histologically proven dipg hospital sainte-anne pediatric gliomas paediatric radiation oncology european economic area marie anne raquin 75Â mg/m2/day 200Â mg/m2/day 2-monthly mri follow tumours central nervous system institute gustave roussy brain stem article chassot conditions privacy policy high dose busulfan high-dose tamoxifen oral alkylating agent article journal pre-irradiation chemotherapy accepting optional cookies stephanie puget thomas roujeau laura negretti
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- Diagnostics and treatment of diffuse intrinsic pontine glioma: where do we stand?
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headline:Radiotherapy with concurrent and adjuvant temozolomide in children with newly diagnosed diffuse intrinsic pontine glioma
description:The purpose of this study is to evaluate the efficacy and toxicity of radiation therapy (RT) with concurrent temozolomide (TMZ) chemotherapy followed by adjuvant TMZ in children with diffuse intrinsic pontine glioma (DIPG). Newly diagnosed patients younger than 18Â years with histologically proven DIPG were treated with focal radiotherapy to a dose of 54Â Gy in 30 fractions along with concurrent daily TMZ (75Â mg/m2/day). Four weeks after completing the initial RTâTMZ schedule, adjuvant TMZ (200Â mg/m2/day, days 1â5) was given every 28Â days up to six cycles. Responses/progressions were assessed by clinical and 2-monthly MRI follow-up studies. Between September 2005 and September 2009, 21 patients with newly diagnosed histologically confirmed DIPG were eligible for this study. Median age at diagnosis was 6.4Â years (range 4â16Â years). At last update in August 2010, 17 children have died, 1 child was alive with progressive disease and 3 with stable disease. Metastatic relapse was documented in the cerebral site in two patients and in spinal cord in two cases. The median time to progression was 7.5Â months (range 28Â daysâ14.5Â months) and the median survival was 11.7Â months (range 26Â daysâ17.5Â months). The 1-year PFS and the 1-year OS were 33 and 50%, respectively. Five patients presented radiological findings compatible with pseudoprogression during the treatment. Haematological toxicity (Grade III/IV thrombocytopenia and leucopenia) was the most commonly found and led to dose reductions of TMZ in 58% of the patients. TMZ with radiation therapy has not yielded any significant improvement in outcome of children with DIPG and is associated with higher toxicity compared with radiotherapy alone. Novel treatment modalities are needed to improve the outcome of these patients.
datePublished:2011-08-20T00:00:00Z
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Brainstem glioma
Child
Radiation therapy
Temozolomide
Oncology
Neurology
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headline:Radiotherapy with concurrent and adjuvant temozolomide in children with newly diagnosed diffuse intrinsic pontine glioma
description:The purpose of this study is to evaluate the efficacy and toxicity of radiation therapy (RT) with concurrent temozolomide (TMZ) chemotherapy followed by adjuvant TMZ in children with diffuse intrinsic pontine glioma (DIPG). Newly diagnosed patients younger than 18Â years with histologically proven DIPG were treated with focal radiotherapy to a dose of 54Â Gy in 30 fractions along with concurrent daily TMZ (75Â mg/m2/day). Four weeks after completing the initial RTâTMZ schedule, adjuvant TMZ (200Â mg/m2/day, days 1â5) was given every 28Â days up to six cycles. Responses/progressions were assessed by clinical and 2-monthly MRI follow-up studies. Between September 2005 and September 2009, 21 patients with newly diagnosed histologically confirmed DIPG were eligible for this study. Median age at diagnosis was 6.4Â years (range 4â16Â years). At last update in August 2010, 17 children have died, 1 child was alive with progressive disease and 3 with stable disease. Metastatic relapse was documented in the cerebral site in two patients and in spinal cord in two cases. The median time to progression was 7.5Â months (range 28Â daysâ14.5Â months) and the median survival was 11.7Â months (range 26Â daysâ17.5Â months). The 1-year PFS and the 1-year OS were 33 and 50%, respectively. Five patients presented radiological findings compatible with pseudoprogression during the treatment. Haematological toxicity (Grade III/IV thrombocytopenia and leucopenia) was the most commonly found and led to dose reductions of TMZ in 58% of the patients. TMZ with radiation therapy has not yielded any significant improvement in outcome of children with DIPG and is associated with higher toxicity compared with radiotherapy alone. Novel treatment modalities are needed to improve the outcome of these patients.
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Brainstem glioma
Child
Radiation therapy
Temozolomide
Oncology
Neurology
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