title: [Antiangiogenic treatment of pediatric CNS tumors in Hungary with the Kieran schedule].
abstract: In Hungary a new oral antiangiogenic treatment was introduced in cases of primary chemoresistant or recurrent pediatric CNS tumors, called Kieran schedule. The early results of this treatment were analyzed. From 2010 at Semmelweis University on individual decisions a daily combined per oral treatment was introduced in pediatric patients with recurrent or progressive CNS tumor (Kieran schedule: thalidomid, celecoxib, etoposid and cyclophosphamid). Efficacy of therapy was analyzed in terms of demographic data, histology, side effects and tolerability in a retrospective manner. From 2010 through 2013, twenty patients were treated with Kieran schedule (medulloblastoma: 3, ependymoma: 5, anaplastic astrocytoma: 2, GBM: 4, plexus choroideus carcinoma: 1, central primitive neuroectodermal tumor: 1, optic glioma: 2, brainstem tumor: 2). Median treatment time and median progression-free survival were 0.60 and 0.61 years, respectively. Based on the preliminary analysis of a limited cohort of patients, the therapy was efficient in those cases of medulloblastoma, ependymoma, high-grade and optic gliomas, where the expected survival time was more than 3 months at start of treatment. Side effects were slight myelosuppresion in terms of previous therapy, 16% transient ischemic attack (TIA)-like episodes. During therapy patients could live their everyday life. Kieran schedule was well-tolerable and efficient with good quality of life in certain cases of pediatric CNS tumors.
authors.affiliation: II. Sz. Gyermekklinika, Semmelweis Egyetem, Budapest, Hungary. hauserpeti@yahoo.com.
authors.forename: Péter
authors.initials: P
authors.lastname: Hauser
authors.affiliation: II. Sz. Gyermekklinika, Semmelweis Egyetem, Budapest, Hungary. hauserpeti@yahoo.com.
authors.forename: Ildikó
authors.initials: I
authors.lastname: Vancsó
authors.affiliation: II. Sz. Gyermekklinika, Semmelweis Egyetem, Budapest, Hungary. hauserpeti@yahoo.com.
authors.forename: Tímea
authors.initials: T
authors.lastname: Pócza
authors.affiliation: II. Sz. Gyermekklinika, Semmelweis Egyetem, Budapest, Hungary. hauserpeti@yahoo.com.
authors.forename: Dezső
authors.initials: D
authors.lastname: Schuler
authors.affiliation: II. Sz. Gyermekklinika, Semmelweis Egyetem, Budapest, Hungary. hauserpeti@yahoo.com.
authors.forename: Miklós
authors.initials: M
authors.lastname: Garami
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001254:Astrocytoma / Q000188:drug therapy; D001853:Bone Marrow / Q000187:drug effects; D001932:Brain Neoplasms / Q000188:drug therapy*; D020295:Brain Stem Neoplasms / Q000188:drug therapy; D002277:Carcinoma / Q000188:drug therapy; D000068579:Celecoxib; D002528:Cerebellar Neoplasms / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D016545:Choroid Plexus Neoplasms / Q000188:drug therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D004806:Ependymoma / Q000188:drug therapy; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006814:Hungary; D002546:Ischemic Attack, Transient / Q000139:chemically induced; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy; D018242:Neuroectodermal Tumors, Primitive / Q000188:drug therapy; D020339:Optic Nerve Glioma / Q000188:drug therapy; D011720:Pyrazoles / Q000008:administration & dosage; D011788:Quality of Life; D012189:Retrospective Studies; D013449:Sulfonamides / Q000008:administration & dosage; D013792:Thalidomide / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D013792:Thalidomide; D005047:Etoposide; D003520:Cyclophosphamide; D000068579:Celecoxib