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.
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.
Park
Jun Eun
JE
Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
Kang
Joseph
J
Yoo
Keon Hee
KH
Sung
Ki Woong
KW
Koo
Hong Hoe
HH
Lim
Do Hoon
DH
Shin
Hyung Jin
HJ
Kang
Hyoung Jin
HJ
Park
Kyung Duk
KD
Shin
Hee Young
HY
Kim
Il Han
IH
Cho
Byung-Kyu
BK
Im
Ho Joon
HJ
Seo
Jong Jin
JJ
Park
Hyeon Jin
HJ
Park
Byung-Kiu
BK
Ahn
Hyo Seop
HS
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