TY - JOUR
T1 - High-risk medulloblastoma
T2 - A pediatric oncology group randomized trial of chemotherapy before or after radiation therapy (POG 9031)
AU - Tarbell, Nancy J.
AU - Friedman, Henry
AU - Polkinghorn, William R.
AU - Yock, Torunn
AU - Zhou, Tianni
AU - Chen, Zhengjia
AU - Burger, Peter
AU - Barnes, Patrick
AU - Kun, Larry
N1 - Publisher Copyright:
© 2013 by The American Society of Hematology.
PY - 2013/8/10
Y1 - 2013/8/10
N2 - Purpose: To compare event-free survival (EFS) in children with high-risk medulloblastoma randomly assigned to receive either chemotherapy before radiation or chemotherapy after radiation. Patients and Methods: One hundred twelve patients were randomly assigned to each arm. Criteria used to categorize patients as high risk included M1-4 disease by modified Chang staging classification, T3b/T4 disease, or greater than 1.5 cm3 of residual tumor after surgery. Postoperatively, children with high-risk medulloblastoma were randomly assigned to two arms, either chemotherapy entailing three cycles of cisplatin and etoposide before radiation (chemotherapy first [CT1]) or the same chemotherapy regimen after radiation (radiation therapy first [RT1]). Both groups received consolidation chemotherapy consisting of vincristine and cyclophosphamide. Results: The median follow-up time was 6.4 years. Five-year EFS was 66.0% in the CT1 arm and 70.0% in the RT1 arm (P = .54), and 5-year overall survival in the two groups was 73.1% and 76.1%, respectively (P = .47). In the CT1 arm, 40 of the 62 patients with residual disease achieved either complete or partial remission. Conclusion: Five-year EFS did not differ significantly whether, after surgery, patients received chemotherapy before or after radiotherapy.
AB - Purpose: To compare event-free survival (EFS) in children with high-risk medulloblastoma randomly assigned to receive either chemotherapy before radiation or chemotherapy after radiation. Patients and Methods: One hundred twelve patients were randomly assigned to each arm. Criteria used to categorize patients as high risk included M1-4 disease by modified Chang staging classification, T3b/T4 disease, or greater than 1.5 cm3 of residual tumor after surgery. Postoperatively, children with high-risk medulloblastoma were randomly assigned to two arms, either chemotherapy entailing three cycles of cisplatin and etoposide before radiation (chemotherapy first [CT1]) or the same chemotherapy regimen after radiation (radiation therapy first [RT1]). Both groups received consolidation chemotherapy consisting of vincristine and cyclophosphamide. Results: The median follow-up time was 6.4 years. Five-year EFS was 66.0% in the CT1 arm and 70.0% in the RT1 arm (P = .54), and 5-year overall survival in the two groups was 73.1% and 76.1%, respectively (P = .47). In the CT1 arm, 40 of the 62 patients with residual disease achieved either complete or partial remission. Conclusion: Five-year EFS did not differ significantly whether, after surgery, patients received chemotherapy before or after radiotherapy.
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U2 - 10.1200/JCO.2012.43.9984
DO - 10.1200/JCO.2012.43.9984
M3 - Article
C2 - 23857975
AN - SCOPUS:84886726351
SN - 0732-183X
VL - 31
SP - 2936
EP - 2941
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 23
ER -