title: Survival of patients with medulloblastoma treated with carboplatin and etoposide before and after radiotherapy.
abstract: BACKGROUND
  Medulloblastoma represents 20% of all tumors of the central nervous system. Patients with partial resection of the tumor and those with extension into the neuraxis at diagnosis have been identified as high-risk patients. The objective of our study was to determine tumor response, survival rates and toxicity with a new scheme of treatment with carboplatin, etoposide and radiotherapy.
  
  
  METHODS
  All patients received chemotherapy with carboplatin and etoposide every 4 weeks for four courses, hyperfractionated radiotherapy, and another four courses of the above chemotherapy scheme. Tumor response was classified, and global and disease-free survival rates were calculated according to the actuarial survival method.
  
  
  RESULTS
  A total of 26 patients were included, with a median age of 6.9 years. Nineteen achieved complete response after the first four courses of chemotherapy, and two more had a complete response after radiotherapy. A total of seven children have died, three of whom did not respond to initial treatment. Global and disease-free survival rates were 69% and 64%, respectively, at 60 months of follow-up. There was no renal or auditory toxicity. Hematological toxicity was transitory and reversible.
  
  
  CONCLUSIONS
  This scheme of treatment is effective and can be safely used for pediatric patients with high-risk medulloblastomas. Toxicity was not significant, and survival is similar to other reports.
authors.affiliation: Departamento de Oncología, Hospital de Pediatría, México, D.F.
authors.forename: E
authors.initials: E
authors.lastname: Lopez-Aguilar
authors.forename: A C
authors.initials: AC
authors.lastname: Sepulveda-Vildosola
authors.forename: H
authors.initials: H
authors.lastname: Rivera-Marquez
authors.forename: F
authors.initials: F
authors.lastname: Cerecedo-Diaz
authors.forename: E
authors.initials: E
authors.lastname: Santacruz-Castillo
authors.forename: M
authors.initials: M
authors.lastname: Valdez-Sanchez
authors.forename: J
authors.initials: J
authors.lastname: Arias-Gomez
authors.forename: G
authors.initials: G
authors.lastname: Quintana-Roldan
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D008527:Medulloblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D012074:Remission Induction
chemical_list: D005047:Etoposide; D016190:Carboplatin