Back to Search Start Over

Acute toxicity of chemotherapy in central nervous system germ cell tumour patients according to age.

Authors :
Palenzuela, Gilles
Schiffler, Camille
Frappaz, Didier
Peyrl, Andreas
Gerber, Nicolas U.
Kortmann, Rolf-Dieter
Philippe, Michael
Zimmermann, Martin
Murray, Matthew J.
Nicholson, James C.
Calaminus, Gabriele
Faure-Conter, Cécile
Source :
Frontiers in Oncology; 2024, p01-09, 9p
Publication Year :
2024

Abstract

Background: SIOP-CNS-GCT-II European trial was opened for the treatment of patients of any age with central nervous system germ cell tumour (CNS-GCT). Four courses of pre-irradiation chemotherapy were delivered. The influence of patient age on chemotherapy related acute toxicity (CRAT) was assessed. Methods: CRAT was analysed according to age-groups: children (aged ≤11 years), adolescents (aged 12-17 years), adults (aged ≥18 years) and to chemotherapy type: CarboPEI (alternating etoposide-carboplatin/etoposide- ifosfamide) for non-metastatic germinoma; PEI (cisplatin-etoposide- ifosfamide) for standard-risk non-germinomatous GCT (NGGCT); PEI and high-dose PEI (HD-PEI), for high-risk or poorly responsive NGGCTs. Results: 296 patients were assessable for CRAT: 105 children, 121 adolescents, 70 adults (max age: 41 years). Median cumulative doses/m² of chemotherapy were similar among age-groups. The proportion of germinoma over NGGCT (and accordingly use of CarboPEI chemotherapy) was higher in the adult groups (79%) versus the other two groups (62%). Delay in chemotherapy ≥7 days was noticed in 27%, 38%, and 19% of children, adolescents, and adults, respectively. Grade ≥3 haematological and non-haematological adverse events (AEs) were observed in 94%/31%, 97%/36%, and 77%/21% of children, adolescents, and adults, respectively. No toxic death was reported. Grade ≥3 AEs and delayed chemotherapies were significantly rarer in adults when compared with adolescents, even when adjusted on chemotherapy type: odds ratio: 0.1 [95% CI 0.02-0.4], and 0.2 [95%CI 0.1-0.4] in the group treated with CarboPEI. Conclusion: Adult patients can be treated safely with a chemotherapy intensive protocol, with even less toxicity than that observed in adolescents. Further work is required to understand age-related differences regarding toxicity. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
2234943X
Database :
Complementary Index
Journal :
Frontiers in Oncology
Publication Type :
Academic Journal
Accession number :
178723234
Full Text :
https://doi.org/10.3389/fonc.2024.1421418