umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
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
Visa övriga samt affilieringar
2017 (Engelska)Ingår i: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 81, s. 206-225Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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 OncologyeLow Grade Glioma (SIOP LGG) Committee launched a randomised trial involving 118 institutions and 11 countries to investigate the addition of etoposide (100 mg/m(2), days 1, 2 & 3) to a four-course induction of vincristine (1.5 mg/m(2) x 10 wkly) and carboplatin (550 mg/m(2) 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 on disease outcomes of 'duration of therapy' and 'age at stopping therapy'.

Ort, förlag, år, upplaga, sidor
Elsevier, 2017. Vol. 81, s. 206-225
Nyckelord [en]
Low grade glioma, Childhood, Chemotherapy, Randomised trial
Nationell ämneskategori
Cancer och onkologi Pediatrik
Identifikatorer
URN: urn:nbn:se:umu:diva-139581DOI: 10.1016/j.ejca.2017.04.019ISI: 000404894700025PubMedID: 28649001OAI: oai:DiVA.org:umu-139581DiVA, id: diva2:1143486
Tillgänglig från: 2017-09-21 Skapad: 2017-09-21 Senast uppdaterad: 2018-06-09Bibliografiskt granskad

Open Access i DiVA

fulltext(1446 kB)117 nedladdningar
Filinformation
Filnamn FULLTEXT01.pdfFilstorlek 1446 kBChecksumma SHA-512
7c2e9a01296ee7c24f900331795824a53b9d397f246d3f63d0bb5cefb9efa946009f0cd955c49cf6c0df376163c52b7f39b4c11d5ec828690b6b9c2880cc6edc
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMed

Personposter BETA

Sandström, Per EricDe Salvo, Gian Luca

Sök vidare i DiVA

Av författaren/redaktören
Sandström, Per EricDe Salvo, Gian Luca
Av organisationen
Pediatrik
I samma tidskrift
European Journal of Cancer
Cancer och onkologiPediatrik

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 117 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 193 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf