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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.

Park JE, Kang J, Yoo KH, Sung KW, Koo HH, Lim do H, Shin HJ, Kang HJ, Park KD, Shin HY, Kim IH, Cho BK, Im HJ, Seo JJ, Park HJ, Park BK, Ahn HS - J. Korean Med. Sci. (2010)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.

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.

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Study progression following salvage chemotherapy (n=13).*2nd HDCT was refused by a patient's guardian.CR, complete response; PR, partial response; PD, progressive disease; SD, stable disease.
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Figure 3: Study progression following salvage chemotherapy (n=13).*2nd HDCT was refused by a patient's guardian.CR, complete response; PR, partial response; PD, progressive disease; SD, stable disease.

Mentions: Of 6 patients with PR status pre-HDCT: 3 achieved CR status after HDCT1 and received optional HDCT2; 2 patients, #6 and #13 maintain CR status and are still alive. Patient #4, who achieved PR status after HDCT1 did not receive HDCT2 because the patient's guardian refused tandem transplantation. The disease of patient #15 progressed so he could not receive tandem transplantation, and patient #14 died of TRM at HDCT1 and ASCT (Fig. 3). These 3 patients who did not receive HDCT2 all died. The patients who were at PR status pre-HDCT could achieve long-term survival but patients who could not receive tandem transplantation died.


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.

Park JE, Kang J, Yoo KH, Sung KW, Koo HH, Lim do H, Shin HJ, Kang HJ, Park KD, Shin HY, Kim IH, Cho BK, Im HJ, Seo JJ, Park HJ, Park BK, Ahn HS - J. Korean Med. Sci. (2010)

Study progression following salvage chemotherapy (n=13).*2nd HDCT was refused by a patient's guardian.CR, complete response; PR, partial response; PD, progressive disease; SD, stable disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908784&req=5

Figure 3: Study progression following salvage chemotherapy (n=13).*2nd HDCT was refused by a patient's guardian.CR, complete response; PR, partial response; PD, progressive disease; SD, stable disease.
Mentions: Of 6 patients with PR status pre-HDCT: 3 achieved CR status after HDCT1 and received optional HDCT2; 2 patients, #6 and #13 maintain CR status and are still alive. Patient #4, who achieved PR status after HDCT1 did not receive HDCT2 because the patient's guardian refused tandem transplantation. The disease of patient #15 progressed so he could not receive tandem transplantation, and patient #14 died of TRM at HDCT1 and ASCT (Fig. 3). These 3 patients who did not receive HDCT2 all died. The patients who were at PR status pre-HDCT could achieve long-term survival but patients who could not receive tandem transplantation died.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.

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.

Show MeSH
Related in: MedlinePlus