title: Efficacy of high-dose chemotherapy and autologous stem cell transplantation in patients with relapsed medulloblastoma: a report on the Korean Society for Pediatric Neuro-Oncology (KSPNO)-S-053 study.
abstract: The efficacy and toxicity of high-dose chemotherapy and autologous stem cell transplantation (HDCT/ASCT) were investigated for improving the outcomes of patients with relapsed medulloblastoma. A total of 15 patients with relapsed medulloblastoma were enrolled in the KSPNO-S-053 study from May 2005 to May 2007. All patients received approximately 4 cycles of salvage chemotherapy after relapse. Thirteen underwent HDCT/ASCT; CTE and CM regimen were employed for the first HDCT (HDCT1) and second HDCT (HDCT2), respectively, and 7 underwent HDCT2. One transplant related mortality (TRM) due to veno-occlusive disease (VOD) occurred during HDCT1 but HDCT2 was tolerable with no further TRM. The 3-yr overall survival probability and event-free survival rates +/-95% confidence intervals (CI) were 33.3+/-12.2% and 26.7% +/-11.4%, respectively. When analysis was confined to only patients who had a complete response (CR) or partial response (PR) prior to HDCT, the probability of 3-yr overall survival rates +/-95% CI was 40.0+/-15.5%. No patients with stable disease (SD) or progressive disease (PD) survived. Survival rates from protocol KSPNO-S-053 are encouraging and show that tumor status prior to HDCT/ASCT is an important factor to consider for improving survival rates of patients with relapsed medulloblastoma.
authors.affiliation: Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jun Eun
authors.initials: JE
authors.lastname: Park
authors.forename: Joseph
authors.initials: J
authors.lastname: Kang
authors.forename: Keon Hee
authors.initials: KH
authors.lastname: Yoo
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Sung
authors.forename: Hong Hoe
authors.initials: HH
authors.lastname: Koo
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Lim
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Hyoung Jin
authors.initials: HJ
authors.lastname: Kang
authors.forename: Kyung Duk
authors.initials: KD
authors.lastname: Park
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Shin
authors.forename: Il Han
authors.initials: IH
authors.lastname: Kim
authors.forename: Byung-Kyu
authors.initials: BK
authors.lastname: Cho
authors.forename: Ho Joon
authors.initials: HJ
authors.lastname: Im
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Seo
authors.forename: Hyeon Jin
authors.initials: HJ
authors.lastname: Park
authors.forename: Byung-Kiu
authors.initials: BK
authors.lastname: Park
authors.forename: Hyo Seop
authors.initials: HS
authors.lastname: Ahn
mesh_terms: D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D056910:Republic of Korea; D016879:Salvage Therapy; D014182:Transplantation, Autologous; D055815:Young Adult