Simultaneous radiochemotherapy in pediatric patients with high-grade glioma: a phase I study.
BACKGROUND
Sandwich chemotherapy as first postoperative treatment might cause resistance to ensuing irradiation. Simultaneous radiochemotherapy might prevent this.


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.
Wolff
Johannes E A
JE
Klinik St. Hedwig, Steinmetzstr. 1-3, 93049 Regensburg, Germany. KZVAHITGBM@aol.com
Wagner
Sabine
S
Sindichakis
Marina
M
Pietsch
Thorsten
T
Gnekow
Astrid
A
Kortmann
Rolf-Dieter
RD
Sträter
Ronald
R
Kuehl
Joachim
J
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001254:Astrocytoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000009:adverse effects; D019583:Dose Fractionation, Radiation; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D005910:Glioma / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D011446:Prospective Studies; D013120:Spinal Cord Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery
D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide