Author(s): Fouladi M, Hunt DL, Pollack IF, Dueckers G, Burger PC, et al.
Background: The objectives of the current study were to determine the outcome of children who were treated with chemotherapy and radiotherapy on the Children's Cancer Group (CCG) high-grade glioma protocol (CCG-945) who were diagnosed with low-grade gliomas on post hoc central pathologic review and to identify clinical and biologic features associated with prognosis.
Methods: Between 1985 and 1991, 250 children with institutionally classified high-grade gliomas were enrolled on CCG-945. Patients older than 24 months with intracranial lesions were assigned randomly to receive either lomustine, vincristine, and prednisone (control regimen) or the 8-drugs-in-1-day regimen (experimental regimen); younger patients and those with primary spinal cord tumors were assigned nonrandomly to the experimental regimen. Central independent review by 5 neuropathologists led to a reclassification of low-grade glioma in 70 patients, who were the focus of the current study.
Results: The study involved 42 males and 28 females (median age, 7.7 years) with a median follow-up of 10.4 years. At 5 years, the progression-free survival (PFS) rate was 63% +/- 6%, and the overall survival (OS) rate was 79% +/- 5%, compared with a PFS rate of 19% +/- 3% (P < 0.0001) and an OS rate of 22% +/- 3% (P < 0.0001) in the remainder of the cohort. Significantly poorer 5-year PFS was seen in children younger than 24 months, those with fibrillary astrocytoma, and those with posterior fossa tumors. Patients demonstrated a modest improvement in PFS but no improvement in OS compared with children with low-grade gliomas who were treated with contemporary chemotherapy-alone approaches.
Conclusions: The current report calls attention to the importance of central pathologic review in large multiinstitutional trials of children with gliomas and suggests that aggressive front-line combined chemoradiotherapy does not confer a survival advantage in this highly selected population of patients.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/12973849
Author(s): Ostrom QT, Gittleman H, Farah P, Ondracek A, Chen Y, et al.
Author(s): Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, et al.
Author(s): Nelson D, Nelson J, Davis D, Chang C, Griffins T, et al.
Author(s): Parvez T
Author(s): Reese TS, Karnovsky MJ
Author(s): Kreuter J
Author(s): Kreuter J.
Author(s): Delpassand ES, Samarghandi A, Zamanian S, Wolin EM, Hamiditabar M, et al.
Author(s): Humm JL, Sartor O, Parker C, Bruland OS, Macklis R
Author(s): Shore ND
Author(s): Parker C, Nilsson S, Heinrich D, Helle SI, O'Sullivan JM, et al.
Author(s): Chanda N, Kan P, Watkinson LD, Shukla R, Zambre A, et al.
Author(s): Bhattacharyya S, Bhattacharya R, Curley S, McNiven MA, Mukherjee P
Author(s): Arvizo RR, Miranda OR, Thompson MA, Pabelick CM, Bhattacharya R, et al.
Author(s): Arvizo RR, Miranda OR, Moyano DF, Walden CA, Giri K, et al.
Author(s): Bhattacharyya S, Singh RD, Pagano R, Robertson JD, Bhattacharya R, et al.
Author(s): Kudgus RA, Walden CA, McGovern RM, Reid JM, Robertson JD, et al.
Author(s): Kennel SJ, Chappell LL, Dadachova K, Brechbiel MW, Lankford TK, et al.
Author(s): McLaughlin MF, Robertson D, Pevsner PH, Wall JS, Mirzadeh S, et al.
Author(s): Woodward J, Kennel SJ, Stuckey A, Osborne D, Wall J, et al.
Author(s): McLaughlin MF, Woodward J, Boll RA, Wall JS, Rondinone AJ, et al.
Author(s): Miller DC, Koslow M, Budzilovich GN, Burstein DE
Author(s): Joshi RP, Hu Q
Author(s): Joshi RP, Schoenbach KH
Author(s): Roth CC, Tolstykh GP, Payne JA, Kuipers MA, Thompson GL