High-dose carmustine for high-grade gliomas in childhood.
Carmustine (BCNU) has proved to be of value against a variety of primary brain tumors. This agent exhibits a steep dose-response curve in in vitro and animal tumor models and has been proposed for use in high-dose chemotherapy as a single agent or in combination. We conducted a phase II study to assess high-dose BCNU in children with high-grade gliomas. A total of 13 children with high-grade gliomas were treated in a phase II study using high-dose BCNU (800 mg/m2) followed by autologous bone marrow transplantation. Eight patients were newly diagnosed, and five were treated at the time of tumor recurrence. Seven patients had diffuse intrinsic brain-stem gliomas. The response was assessed at 1 month after treatment. Only one objective effect was observed. Five patients had stable disease and seven progressed. The immediate toxicity was mild; however, one patient developed fatal respiratory distress at 50 days after treatment with high-dose BCNU. Dose escalation of BCNU does not seem beneficial in children with high-grade gliomas.
Bouffet
E
E
Pediatric Department, Centre Léon Bérard, Lyon, France.
Khelfaoui
F
F
Philip
I
I
Biron
P
P
Brunat-Mentigny
M
M
Philip
T
T
D000293:Adolescent; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D016026:Bone Marrow Transplantation; D001932:Brain Neoplasms / Q000188:drug therapy / Q000628:therapy*; D002330:Carmustine / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005910:Glioma / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male
D018906:Antineoplastic Agents, Alkylating; D002330:Carmustine