title: Second complete remission of relapsed medulloblastoma induced by metronomic chemotherapy.
abstract: Prognosis for children with relapsed medulloblastoma remains poor. Metronomic chemotherapy may offer some benefit to patients treated initially with intensive regimens. However, dosing and duration of such palliative treatment have not been systematically studied. Here we describe a child with medulloblastoma relapsing after initial high-dose chemotherapy and standard radiotherapy. The patient was then treated with metronomic chemotherapy and achieved second complete remission after 21 months of treatment. Three months off therapy he relapsed again and died from progressive disease. This case illustrates the potential benefit of metronomic chemotherapy but also shows the uncertainty of when to stop metronomic chemotherapy while balancing toxicity.
authors.affiliation: Pediatric Oncology Department, University Hospital Brno, Masaryk University Brno, Brno, Czech Republic. jsterb@fnbrno.cz
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Sterba
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Pavelka
authors.forename: Nicolas
authors.initials: N
authors.lastname: Andre
authors.forename: Jiri
authors.initials: J
authors.lastname: Ventruba
authors.forename: Jarmila
authors.initials: J
authors.lastname: Skotakova
authors.forename: Viera
authors.initials: V
authors.lastname: Bajciova
authors.forename: Danica
authors.initials: D
authors.lastname: Bronisova
authors.forename: Lenka
authors.initials: L
authors.lastname: Dubska
authors.forename: Dalibor
authors.initials: D
authors.lastname: Valik
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002528:Cerebellar Neoplasms / Q000188:drug therapy*; D002648:Child; D003131:Combined Modality Therapy; D055870:Drug Chronotherapy; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009367:Neoplasm Staging; D019635:Neurosurgical Procedures; D011878:Radiotherapy; D012074:Remission Induction