Academic Journal
A European randomised controlled trial of the addition of etoposide to standard vincristine and carboplatin induction as part of an 18-month treatment programme for childhood (≤16 years) low grade glioma – A final report
| العنوان: | A European randomised controlled trial of the addition of etoposide to standard vincristine and carboplatin induction as part of an 18-month treatment programme for childhood (≤16 years) low grade glioma – A final report |
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| المؤلفون: | Gnekow A. K., Walker D. A., Kandels D., Picton S., Perilongo G., Grill J., Stokland T., Sandstrom P. E., Warmuth-Metz M., Pietsch T., Giangaspero F., Schmidt R., Faldum A., Kilmartin D., De Paoli A., De Salvo G. L., Slavc I., Walker D., Clausen N., Arola M., Jonsson O. G., Cruz O., Navajas A., Teijeiro A., Kalifa C., Raquin M. -A., Verlooy J., Hans V., Scheurlen W., Hainfellner J., Ironside J., Robson K., Skullerud K., Scheie D., NN, Ruchoux M. -M., Jouvet A., Figarella-Branger D., Lellouch-Toubiana A., Prayer D., Calderone M., Jaspan T., Bakke S. J., Vazquez E., Couanet D., Kortmann R. D., Diekmann K., Scarzello G., Taylor R., Lote K., Giralt J., Carrie C., Habrand J. L., Soerensen N., Czech T., Chumas P., Gustavson B., Zerah M., Wabbels B., Pinello M. L., Fielder A., Simmons I., Christoffersen T., Calaminus G., Brockmann K., Straeter R., Ebinger F., Hernaiz-Driever P., Lackner H., Kennedy C., Glaser A., Stromberg B., Indiano J. M., Rodary C., Bouffet E., Frappaz D., Emser A., Stephens S., Machin D., Le Deley M. -C., Egeland T., Freemann C., Schrappe M., Sposto R. |
| المساهمون: | Gnekow, A. K., Walker, D. A., Kandels, D., Picton, S., Perilongo, G., Grill, J., Stokland, T., Sandstrom, P. E., Warmuth-Metz, M., Pietsch, T., Giangaspero, F., Schmidt, R., Faldum, A., Kilmartin, D., De Paoli, A., De Salvo, G. L., Slavc, I., Walker, D., Clausen, N., Arola, M., Jonsson, O. G., Cruz, O., Navajas, A., Teijeiro, A., Kalifa, C., Raquin, M. -A., Verlooy, J., Hans, V., Scheurlen, W., Hainfellner, J., Ironside, J., Robson, K., Skullerud, K., Scheie, D., Nn, Ruchoux, M. -M., Jouvet, A., Figarella-Branger, D., Lellouch-Toubiana, A., Prayer, D., Calderone, M., Jaspan, T., Bakke, S. J., Vazquez, E., Couanet, D., Kortmann, R. D., Diekmann, K., Scarzello, G., Taylor, R., Lote, K., Giralt, J., Carrie, C., Habrand, J. L., Soerensen, N., Czech, T., Chumas, P., Gustavson, B., Zerah, M., Wabbels, B., Pinello, M. L., Fielder, A., Simmons, I., Christoffersen, T., Calaminus, G., Brockmann, K., Straeter, R., Ebinger, F., Hernaiz-Driever, P., Lackner, H., Kennedy, C., Glaser, A., Stromberg, B., Indiano, J. M., Rodary, C., Bouffet, E., Frappaz, D., Emser, A., Stephens, S., Machin, D., Le Deley, M. -C., Egeland, T., Freemann, C., Schrappe, M., Sposto, R. |
| بيانات النشر: | Elsevier Ltd Oxford, OX5 1GB Regno Unito |
| سنة النشر: | 2017 |
| المجموعة: | Sapienza Università di Roma: CINECA IRIS |
| مصطلحات موضوعية: | chemotherapy, childhood, low grade glioma, randomised trial, antineoplastic combined chemotherapy protocol, brain neoplasm, carboplatin, child, preschool, etoposide, female, glioma, human, induction chemotherapy, infant, male, survival analysi, vincristine |
| الوصف: | Background The use of chemotherapy to manage newly diagnosed low grade glioma (LGG) was first introduced in the 1980s. One randomised trial has studied two- versus four-drug regimens with a duration of 12 months of treatment after resection. Methods Within the European comprehensive treatment strategy for childhood LGG, the International Society of Paediatric Oncology–Low Grade Glioma (SIOP LGG) Committee launched a randomised trial involving 118 institutions and 11 countries to investigate the addition of etoposide (100 mg/m2, days 1, 2 & 3) to a four-course induction of vincristine (1.5 mg/m2 × 10 wkly) and carboplatin (550 mg/m2 q 3 weekly) as part of 18-month continuing treatment programme. Patients were recruited after imaging diagnosis, resection or biopsy with progressive disease/symptoms. Some 497 newly diagnosed patients (M/F 231/266; median age 4.26 years (interquartile range (IQR) 2.02–7.06)) were randomised to receive vincristine carboplatin (VC) (n = 249) or VC plus etoposide (VCE) during induction (n = 248), stratified by age and tumour site. Findings No differences between the two arms were found in term of survival and radiological response. Response and non-progression rates at 24 weeks for VC and VCE, were 46% versus 41%, and 93% versus 91% respectively; 5-year Progression-Free Survival (PFS) and Overall Survival (OS) were 46% (StDev 3.5) versus 45% (StDev 3.5) and 89% (StDev 2.1) versus 89% (StDev 2.1) respectively. Age and diencephalic syndrome are adverse clinical risk factors for PFS and OS. 5-year OS for patients in early progression at week 24 were 46% (StDev 13.8) and 49% (StDev 16.5) in the two arms, respectively. Interpretation The addition of etoposide to VC did not improve PFS or OS. High non-progression rates at 24 weeks justify retaining VC as standard first-line therapy. Infants with diencephalic syndrome and early progression need new treatments to be tested. Future trials should use neurological/visual and toxicity outcomes and be designed to discriminate between the impact ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/28649001; info:eu-repo/semantics/altIdentifier/wos/WOS:000404894700025; volume:81; firstpage:206; lastpage:225; numberofpages:20; journal:EUROPEAN JOURNAL OF CANCER; http://hdl.handle.net/11573/1301732; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85021053329 |
| DOI: | 10.1016/j.ejca.2017.04.019 |
| الاتاحة: | http://hdl.handle.net/11573/1301732 https://doi.org/10.1016/j.ejca.2017.04.019 |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.3CC8F281 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.ejca.2017.04.019 |
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