HYALURONIDASE ADDITIONAL TO STANDARD CHEMOTHERAPY IMPROVES OUTCOME FOR CHILDREN WITH MALIGNANT BRAIN-TUMORS

Ex vivo experiments with vital brain tumor samples I;how that hyaluron idase enhances the permeation of carboplatin into tumor tissue with a matrix rich in hyaluronic acid. We achieved long-lasting second remiss ions for children with relapsed malignant brain tumors treated with ca rboplatin, etoposide and this enzyme. Thereafter, we initiated a pilot study where we added hyaluronidase to the first line standard therapy to prevent the deadly relapses right from the beginning. All 19 patie nts with malignant brain tumors admitted to our pediatric neurooncolog ical center from 1992 to 1994 were included in the study. Kaplan-Meier estimation of event-free survival and overall survival after 3 years follow-up indicates a significantly better outcome for the hyaluronida se-treated group. The children receiving supportive hyaluronidase suff ered significantly less relapses (P = 0.034) and had a significantly b etter chance for survival (P = 0.045) compared to the historical contr ol of 21 children treated with the same standard regimen but without s upportive hyaluronidase (product limit analysis and the log-rank test, P < 0.05). Children aged >3 years receiving hyaluronidase together wi th primary treatment seemed to gain the most benefit. (C) 1998 Elsevie r Science Ireland Ltd. All rights reserved.