Related Experiment Video
Updated: Aug 16, 2026
The Clinical Application of Tumor Treating Fields Therapy in Glioblastoma
Published on: April 16, 2019
High-dose methotrexate prior to simultaneous radiochemotherapy in children with malignant high-grade gliomas
Sabine Wagner1, Christiane Reinert, Hans-Jörg Schmid
1Department of Pediatric Oncology, Krankenhaus der Barmherzigen Brüder Klinik St. Hedwig, Steinmetzstr. 1-3, D-93049 Regensburg, Germany. sabine.wagner@barmherzige-regensburg.de
Background:
Preradiation chemotherapy including methotrexate (MTX) was effective in children with completely resected high-grade gliomas (HGG). The specific role of MTX remains uncertain.
Patients And Methods:
Children with newly diagnosed HGG and diffuse intrinsic pontine gliomas (DIPG) were enrolled. Two cycles of HD-MTX (5 mg/m2) were given prior to simultaneous radiochemotherapy (SRCT). Response was evaluated two weeks after SRCT.
Results:
Of 26 children (17 males, median age: 10.3 years) tumor grading was WHO IV (n=9), III (n=10), II/I (n=4, DIPG), unknown (n=3, DIPG). Fourteen tumors were resected. III/IV toxicity after SRCT was: 10/19 anemia, 15/19 leukocytopenia, 12/19 thrombocytopenia, 8/18 infection. No IV infection, gastrointestinal, hepatic or dermal toxicity or toxic death was seen. Stable disease or better was seen in 95.3% (CCR:2, CR:1, PR:8, SD:9, PD:1, unknown:5).
Conclusion:
HD-MTX prior to SRCT is well tolerated and feasible. A randomized trial evaluating the effect of HD-MTX on survival is justified.
