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Simultaneous radiochemotherapy in pediatric patients with high-grade glioma: a phase I study
Johannes E A Wolff1, Sabine Wagner, Marina Sindichakis
1Klinik St. Hedwig, Steinmetzstr. 1-3, 93049 Regensburg, Germany. KZVAHITGBM@aol.com
Background:
Sandwich chemotherapy as first postoperative treatment might cause resistance to ensuing irradiation. Simultaneous radiochemotherapy might prevent this.
Patients And Methods:
Twenty-nine children with high-grade glioma were treated from 1997-1999. The median age was 11.1 years. Tumor locations included: cerebral cortex 12, deep cerebral locations 11, cerebellum 3, spinal cord 3. Pons was excluded. Total (n = 9), subtotal (n = 3) and partial (n = 9) tumor resection or biopsy (n = 7) were followed by radiochemotherapy: fractionated radiation (1.8 Gyld up to 59.4 Gy) was given simultaneously with two cycles of chemotherapy (cisplatin 20 mg/m2/d x 5d, etoposide 100 mg/m2/d x 3d, and cisplatin, etoposide, ifosfamide: 1.5 g/m2/d). The data of a previous protocol (Cancer 89: 2131-7, 2000) in the same population were used as controls.
Results:
Early progressive disease (PD 2 out of 25 patients) was significantly less frequent as compared to the control group (p = 0.031). The toxicity appeared tolerable.