Recurrent intracranial ependymoma in children: Salvage therapy with oral etoposide

Chronic oral VP-16 (etoposide) is a chemotherapy regimen with a wide applic ation in oncology and documented efficacy against germ cell tumors, lymphom as, Kaposi's sarcoma, and primary brain tumors. This study was performed to assess the toxicity and activity of chronic oral etoposide in the manageme nt of children with recurrent intracranial nondisseminated ependymoma, Twel ve children (median age of 8 years) with recurrent ependymoma who were refr actory to surgery, radiotherapy, and chemotherapy (carboplatinum or the com bination of procarbazine, lomustine, and vincristine) were treated with chr onic oral etoposide (50 mg/m(2)/day). Treatment-related complications inclu ded the following: alopecia (10 children), diarrhea (6), weight loss (5), a nemia (4), neutropenia (3), and thrombocytopenia (3), Three children requir ed transfusion (two with packed red blood cells; two with platelets), and t wo children developed neutropenic fever. No treatment-related deaths occurr ed. Six children (50%) demonstrated either a radiographic response (two chi ldren, both with partial response) or stable disease (four children) with a median duration of response or stable disease of 7 months, In this small c ohort of children with recurrent intracranial ependymoma, oral etoposide wa s well tolerated, produced modest toxicity, and had apparent activity. (C) 2001 by Elsevier Science Inc. All rights reserved.