CARBOPLATIN AND ETOPOSIDE WITH HYPERFRACTIONATED RADIOTHERAPY IN CHILDREN WITH NEWLY-DIAGNOSED DIFFUSE PONTINE GLIOMAS - A PHASE I II STUDY/

Background. Diffuse pontine gliomas remain one of the most lethal oi p ediatric malignancies despite the use of increasingly intensive therap ies. We delivered intensive chemotherapy during and following 70.2 Gy of hyperfractionated radiation therapy in an attempt to improve surviv al. Procedure. Nine consecutive children with diffuse pontine gliomas were treated on this single arm study. Carboplatin, given in combinati on with fixed dose etoposide, was escalated in successive cohorts to d etermine its maximum tolerated systemic exposure (AUG). Outcome was co ded based on imaging characteristics and clinical status. Results. Eig ht of the nine children on this-study died of their disease at a media n of 44 weeks, essentially the same survival as those treated on a pre vious Pediatric Oncology Group study using hyperfractionated radiation therapy alone. Toxicity was almost exclusively hematologic and not as sociated with significant morbidity. Conclusions. The use of concurren t carboplatin and etoposide with hyperfractionated radiation therapy d id not appear to improve the survival in this group of children with d iffuse pontine gliomas. The toxicity of this chemotherapy during radia tion therapy was primarily hematologic and well tolerated. New approac hes to the treatment of these tumors need to be investigated. (C) 1998 Wiley-Liss. Inc.