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Chemotherapy for advanced CNS ependymoma.
M K Gornet1, J C Buckner, R S Marks
1Division of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA.
Journal of Neuro-Oncology
|March 23, 2000
Summary
Platinum-based chemotherapy shows higher response rates and lower progression in recurrent ependymoma compared to nitrosourea-based regimens. Other chemotherapy combinations were less effective.
Area of Science:
- Neuro-oncology
- Chemotherapy Research
- Clinical Trial Analysis
Background:
- The efficacy of chemotherapy for recurrent ependymoma remains unclear.
- This study aimed to evaluate chemotherapy's benefits in recurrent central nervous system (CNS) ependymoma.
Purpose of the Study:
- To assess the effectiveness of different chemotherapy regimens in patients with recurrent ependymoma.
- To compare response rates and time to progression for platinum-based, nitrosourea-based, and other chemotherapy combinations.
Main Methods:
- Retrospective review of 16 patients with advanced CNS ependymoma treated between 1974-1993.
- Chemotherapy regimens included nitrosourea, platinum, or other combinations (no concurrent nitrosourea and platinum).
- Response was assessed using radiographic imaging and a broader scoring system including clinical criteria.
Main Results:
- Platinum-based chemotherapy yielded higher response rates (67% imaging, 83% scoring) with less progression (0% stable).
- Nitrosourea-based regimens showed lower response rates (25% imaging, 60% scoring) with more stability (10% stable).
- Other regimens had significantly lower response rates (11% imaging, 22% scoring) and higher stability (44% stable). Median time to progression was 6, 10, and 3 months respectively.
Conclusions:
- Platinum-based chemotherapy appears superior for recurrent ependymoma, offering better response and reduced progression.
- Nitrosourea-based regimens are less effective than platinum-based ones.
- Chemotherapy regimens excluding platinum or nitrosourea demonstrated the least efficacy.