High-risk medulloblastoma: a pediatric oncology group randomized trial of chemotherapy before or after radiation therapy (POG 9031).

Published

Journal Article

To compare event-free survival (EFS) in children with high-risk medulloblastoma randomly assigned to receive either chemotherapy before radiation or chemotherapy after radiation.One hundred twelve patients were randomly assigned to each arm. Criteria used to categorize patients as high risk included M1-4 disease by modified Chang staging classification, T3b/T4 disease, or greater than 1.5 cm3 of residual tumor after surgery. Postoperatively, children with high-risk medulloblastoma were randomly assigned to two arms, either chemotherapy entailing three cycles of cisplatin and etoposide before radiation (chemotherapy first [CT1]) or the same chemotherapy regimen after radiation (radiation therapy first [RT1]). Both groups received consolidation chemotherapy consisting of vincristine and cyclophosphamide.The median follow-up time was 6.4 years. Five-year EFS was 66.0% in the CT1 arm and 70.0% in the RT1 arm (P = .54), and 5-year overall survival in the two groups was 73.1% and 76.1%, respectively (P = .47). In the CT1 arm, 40 of the 62 patients with residual disease achieved either complete or partial remission.Five-year EFS did not differ significantly whether, after surgery, patients received chemotherapy before or after radiotherapy.

Full Text

Duke Authors

Cited Authors

  • Tarbell, NJ; Friedman, H; Polkinghorn, WR; Yock, T; Zhou, T; Chen, Z; Burger, P; Barnes, P; Kun, L

Published Date

  • August 2013

Published In

Volume / Issue

  • 31 / 23

Start / End Page

  • 2936 - 2941

PubMed ID

  • 23857975

Pubmed Central ID

  • 23857975

Electronic International Standard Serial Number (EISSN)

  • 1527-7755

International Standard Serial Number (ISSN)

  • 0732-183X

Digital Object Identifier (DOI)

  • 10.1200/JCO.2012.43.9984

Language

  • eng