This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gururangan, S. Articles by Martin, P. L. Search for Related Content PubMed PubMed Citation Articles by Gururangan, S. Articles by Martin, P. L. Social Bookmarking                            What's this?

High-Dose Chemotherapy With Autologous Stem-Cell Rescue in Children and Adults With Newly Diagnosed Pineoblastomas

Sridharan Gururangan, Colleen McLaughlin, Jennifer Quinn, Jeremy Rich, David Reardon, Edward C. Halperin, James Herndon, II, Herbert Fuchs, Timothy George, James Provenzale, Melody Watral, Roger E. McLendon, Allan Friedman, Henry S. Friedman, Joanne Kurtzberg, James Vredenbergh, Paul L. Martin

From the Brain Tumor Center at Duke and the Departments of Pediatrics, Radiation Oncology, Neurology, Neurosurgery, Pathology, Neuro-radiology, Family and Community Medicine, and Bone Marrow Transplantation, Duke University Medical Center, Durham, NC.

Address reprint requests to Sridharan Gururangan, MRCP (UK), The Brain Tumor Center at Duke University Medical Center, Box 3624, DUMC, Durham, NC 27710; email: gurur002{at}mc.duke.edu.

Purpose: We evaluated the usefulness of a treatment regimen that included high-dose chemotherapy (HDC) with autologous stem-cell rescue (ASCR) in patients with newly diagnosed pineoblastoma (PBL).

Patients and Methods: Twelve patients with PBL were initially treated with surgery and induction chemotherapy. All but two patients underwent radiotherapy. Subsequently, all patients received HDC using cyclophosphamide (CTX) + melphalan (MEL) or busulfan (Bu) + MEL regimens and ASCR.

Results: A total of six children and six adults with median ages of 4.2 (range, 0.3 to 19.8 years) and 23 years (range, 23 to 43.7 years), respectively, were treated according to this strategy. Four patients had metastatic disease confined to the neuraxis. Five of 12 patients (42%) had a complete tumor resection at diagnosis. Ten patients received radiotherapy at median doses of 36.0 and 59.4 Gy to the neuraxis and pineal region, respectively. Eleven patients received HDC with CTX + MEL, and one patient received BU + MEL followed by ASCR. Nine patients are alive with no evidence of disease recurrence at a median of 62 months from diagnosis (range, 28 to 125 months), including three patients with metastatic disease and two infants who did not receive any radiotherapy. Three patients have died of progressive disease at 19, 32, and 37 months from diagnosis, respectively. The actuarial 4-year progression-free and overall survivals are 69% (95% confidence interval [CI], 39% to 99%) and 71% (95% CI, 43% to 99%), respectively.

Conclusion: The use of HDC in addition to radiotherapy seems to be an effective treatment for patients with newly diagnosed pineoblastoma.

Presented in part at the Society of Neuro-Oncology Meeting, Washington, DC, November 15–18, 2001.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. Chintagumpala, T. Hassall, S. Palmer, D. Ashley, D. Wallace, K. Kasow, T. E. Merchant, M. J. Krasin, R. Dauser, F. Boop, et al. A pilot study of risk-adapted radiotherapy and chemotherapy in patients with supratentorial PNET Neuro-oncol, January 1, 2009; 11(1): 33 - 40. [Abstract] [Full Text] [PDF]

				M. C. Fruhwald, C. H. Rickert, M. S. O'Dorisio, M. Madsen, M. Warmuth-Metz, G. Khanna, W. Paulus, J. Kuhl, H. Jurgens, P. Schneider, et al. Somatostatin Receptor Subtype 2 Is Expressed by Supratentorial Primitive Neuroectodermal Tumors of Childhood and Can Be Targeted for Somatostatin Receptor Imaging Clin. Cancer Res., May 1, 2004; 10(9): 2997 - 3006. [Abstract] [Full Text] [PDF]