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Research ArticleClinical Studies

Chemotherapy Dose-intensity and Survival for Childhood Medulloblastoma

R.L. SMITH, X. SHI and E.J. ESTLIN
Anticancer Research September 2012, 32 (9) 3885-3892;
R.L. SMITH
1Department of Paediatrics, Wythenshaw Hospital, Manchester, U.K.
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  • For correspondence: rosssmith100@hotmail.com
X. SHI
2Business School, Manchester Metropolitan University, Manchester, U.K.
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E.J. ESTLIN
3Department of Paediatric Oncology, Royal Manchester Children's Hospital, Manchester, U.K.
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Abstract

Aim: To determine the relationship between prescribed dose-intensity of chemotherapy and survival in childhood medulloblastoma. Materials and Methods: A total of 55 trials from 1970-2009 were identified, 30 were eligible for analysis, with individual treatment regimes with 5-year (or more) outcome figures. Relationships of outcome to dose-intensity were analysed using weighted regression. Results: Overall, 2,434 patients were identified, 1,010 were classified as ‘standard’- and 671 as ‘high’-risk patients, with 5-year overall survivals (OS) of 67.2% (95% Confidence Interval=60.5%-73.6%) and 47.6% (95% Confidence Interval=39.5%-55.7%), respectively. A protective effect for chemotherapy versus craniospinal radiotherapy alone (5-year OS of 58.2% versus 51.6%) was found. Individually, vincristine, cisplatin, lomustine (CCNU) and cyclophosphamide appear to confer the most beneficial effect, particularly for high-risk patients. Positive relationships between OS and dose-intensity were found, except for lomustine, with cyclophosphamide offering the greatest protection. Conclusion: Consideration of chemotherapy dose-intensity may further optimise treatment, particularly in the context of risk stratification.

  • Childhood
  • medulloblastoma
  • risk stratification
  • chemotherapy dose intensity
  • radiotherapy
  • relative risk
  • overall survival
  • Received May 20, 2012.
  • Revision received July 21, 2012.
  • Accepted July 23, 2012.
  • Copyright© 2012 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved
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Anticancer Research: 32 (9)
Anticancer Research
Vol. 32, Issue 9
September 2012
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Chemotherapy Dose-intensity and Survival for Childhood Medulloblastoma
R.L. SMITH, X. SHI, E.J. ESTLIN
Anticancer Research Sep 2012, 32 (9) 3885-3892;

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Chemotherapy Dose-intensity and Survival for Childhood Medulloblastoma
R.L. SMITH, X. SHI, E.J. ESTLIN
Anticancer Research Sep 2012, 32 (9) 3885-3892;
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