401. Prognostic factors and treatment results for supratentorial primitive neuroectodermal tumors in children using radiation and chemotherapy: a Childrens Cancer Group randomized trial
- Author
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P Stanley, Jeffrey C. Allen, J R Geyer, P McGuire-Cullen, Bruce H. Cohen, Jerrold M. Milstein, L B Rorke, Jonathan L. Finlay, James M. Boyett, and Paul M. Zeltzer
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Vincristine ,medicine.medical_treatment ,Gastroenterology ,Pineal Gland ,Prednisone ,Lomustine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Neuroectodermal Tumors, Primitive ,Prospective Studies ,Prospective cohort study ,Neuroectodermal tumor ,Child ,Neoplasm Staging ,Chemotherapy ,business.industry ,Brain Neoplasms ,Standard treatment ,Cancer ,Infant ,medicine.disease ,Prognosis ,Combined Modality Therapy ,Surgery ,Radiation therapy ,Oncology ,Child, Preschool ,Female ,business ,Pinealoma ,medicine.drug - Abstract
PURPOSE To determine clinical characteristics and response to treatment for children with supratentorial primitive neuroectodermal tumors (S-PNETs). PATIENTS AND METHODS After surgery and staging, 55 patients aged 1.5 to 19.3 years with S-PNETs were randomized to receive craniospinal radiotherapy (RT) followed by eight cycles of 1-(2-chloro-ethyl)-3-cyclohexylnitrosourea (CCNU), vincristine (VCR), and prednisone (standard treatment) or two cycles of 8-in-1 chemotherapy followed by RT and then eight additional cycles of 8-in-1. RESULTS Three-year Kaplan-Meier estimates (estimate +/- SE) of survival and progression-free survival (PFS) rates for patients with confirmed diagnoses of S-PNET were 57% +/- 8% and 45% +/- 8%, respectively; survival and PFS rates for children with PNETs located in the pineal region were 73% +/- 12% and 61% +/- 13%, respectively, and were significantly different from the other S-PNETs (P < .03). The 8-in-1 arm had greater toxicity than the standard-treatment arm. Distributions of PFS between the two treatment groups were not significantly different (P > .5). Other univariate prognostic factors that influenced PFS included metastasis (M) stage (P < .03: M0 50% +/- 9% v M1-4 0%) and age (P < .02: 1.5 to 2 years 25% +/- 13% v > or = 3 years 53% +/- 9%). CONCLUSION In this first randomized treatment trial for S-PNETs in children, no significant differences were detected between the two treatment groups. M0 and pineal site of involvement were independent predictors of a better outcome. However, survival was better than previously reported.
- Published
- 1995