High-dose carboplatin, thiotepa, and etoposide with autologous stem- cell rescue for patients with recurrent medulloblastoma

Ira J. Dunkel*, James M. Boyett, Allan Yates, Marc Rosenblum, James H. Garvin, Bruce C. Bostrom, Stewart Goldman, Leonard S. Sender, Sharon L. Gardner, Hao Li, Jeffrey C. Allen, Jonathan L. Finlay

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

175 Scopus citations

Abstract

Purpose: Medulloblastoma is a highly lethal disease when it recurs. Very few patients survive with conventional treatment. This study evaluated the use of high-dose carboplatin, thiotepa, and etoposide with autologous stem- cell rescue (ASCR) in patients with recurrent medulloblastoma. Methods: Chemotherapy consisted of carboplatin 500 mg/m2 (or area under the curve = 7 mg/mL · min via Calvert formula) on days -8, -7, and -6; and thiotepa 300 mg/m2 and etoposide 250 mg/m2 on days -5, -4, and -3; followed by ASCR on day 0. In addition to the study-prescribed therapy, 21 patients received other treatment: neurosurgical resection in seven, conventional chemotherapy in 17, and external-beam irradiation in 11 cases. Results: Twenty-three patients with recurrent medulloblastoma, aged two to 44 years (median, 13 years) at ASCR, were treated. Three patients died of treatment-related toxicities within 21 days of ASCR; multiorgan system failure in two, and Aspergillus infection with venoocclusive disease in one. Seven of 23 patients (30%) are event-free survivors at a median of 54 months post-ASCR (range, 24 to 73 months). Kaplan-Meier estimates of event-free (EFS) and overall survival are 34% ± 10% and 46% ±11%, respectively, at 36 months post-ASCR. Conclusion: This strategy may provide long-term survival for some patients with recurrent medulloblastoma.

Original languageEnglish (US)
Pages (from-to)222-228
Number of pages7
JournalJournal of Clinical Oncology
Volume16
Issue number1
DOIs
StatePublished - Jan 1998

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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