THE ROLE OF HIGH-DOSE CHEMOTHERAPY AND STEM-CELL RESCUE IN THE TREATMENT OF MALIGNANT BRAIN-TUMORS

The outcome for the majority of children with malignant brain tumors r emains poor, despite surgery, irradiation and conventional chemotherap y, In an attempt to improve this poor outcome, strategies utilizing hi gh-dose (potentially myeloablative) chemotherapy with autologous stem cell rescue have been developed, These studies, initially conducted in patients with recurrent brain tumors, have now been extended to patie nts with newly diagnosed malignant gliomas and to young children with various malignant brain tumors at diagnosis in an attempt to avoid irr adiation to the brain, The results of several of these studies are sum marized, demonstrating durable disease-free survival for a proportion of patients with recurrent malignant gliomas and medulloblastoma/primi tive neuroectodermal tumors, as well as encouraging preliminary data i n the newly-diagnosed patients.