HIGH-DOSE CHEMOTHERAPY WITH MARROW REINFUSION AND HYPERFRACTIONATED IRRADIATION FOR CHILDREN WITH HIGH-RISK BRAIN-TUMORS

Between November 1990 and March 1993, nine pediatric patients with new ly diagnosed brain tumors having a high risk of failure with standard treatment received high-dose thiotepa/cyclophosphamide chemotherapy fo llowed by autologous bone marrow infusion and involved-field hyperfrac tionated radiation therapy. The presenting diagnoses were brainstem gl ioma (BSC) [6], parietal mixed high-grade oligodendroglioma-astrocytom a [1], thalamic anaplastic astrocytoma [1], and high-grade parietal gl ioma [1]. Following chemotherapy there were two partial responses, one minor response, three with stable disease, and one with progressive d isease. Responses were not evaluated in two patients who had toxic dea ths. Following radiation two patients, one with brainstem glioma and o ne with anaplastic mixed glioma, achieved complete remission. The over all survival is no better than conventional therapy. (C) 1994 Wiley-Li ss, Inc.