PROGNOSTIC FACTORS AND TREATMENT RESULTS FOR SUPRATENTORIAL PRIMITIVENEUROECTODERMAL TUMORS IN CHILDREN USING RADIATION AND CHEMOTHERAPY -A CHILDRENS CANCER GROUP RANDOMIZED TRIAL
Bh. Cohen et al., PROGNOSTIC FACTORS AND TREATMENT RESULTS FOR SUPRATENTORIAL PRIMITIVENEUROECTODERMAL TUMORS IN CHILDREN USING RADIATION AND CHEMOTHERAPY -A CHILDRENS CANCER GROUP RANDOMIZED TRIAL, Journal of clinical oncology, 13(7), 1995, pp. 1687-1696
Purpose: To determine clinical characteristics and response to treatme
nt 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 cranio
spinal radiotherapy (RT) followed by eight cycles of 1-(2-chloro-ethyl
)-3-cyclohexylnitrosourea (CCNU), vincristine (VCR), and prednisone (s
tandard treatment) or two cycles of 8-in-1 chemotherapy followed by RT
and then eight additional cycles of 8-in-1. Results: Three-year Kapla
n-Meier estimates (estimate +/- SE) of survival and progression-free s
urvival (PFS) rates for patients with confirmed diagnoses of S-PNET we
re 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 pr
ognostic factors that influenced PFS included metastasis (M) stage (P
< .03: M(0) 50% +/- 9% v M(1-4) 0%) and age (P < .02: 1.5 to 2 years 2
5% +/- 13% v greater than or equal to 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
. M(0) and pineal site of involvement were independent predictors of a
better outcome. However, survival was better than previously reported
. (C) 1995 by American Society of Clinical Oncology.