Hyperfractionated Accelerated Radiotherapy (HART) with maintenance chemotherapy for metastatic (M1-3) Medulloblastoma--a safety/feasibility study

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Hyperfractionated Accelerated Radiotherapy (HART) with maintenance chemotherapy for metastatic (M1-3) Medulloblastoma--a safety/feasibility study. / Taylor, Roger E; Howman, Andrew J; Wheatley, Keith; Brogden, Elena E; Large, Bridget; Gibson, Michael J; Robson, Keith; Mitra, Dipayan; Saran, Frank; Michalski, Antony; Pizer, Barry L.

In: Radiotherapy & Oncology, Vol. 111, No. 1, 04.2014, p. 41-6.

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Taylor, Roger E ; Howman, Andrew J ; Wheatley, Keith ; Brogden, Elena E ; Large, Bridget ; Gibson, Michael J ; Robson, Keith ; Mitra, Dipayan ; Saran, Frank ; Michalski, Antony ; Pizer, Barry L. / Hyperfractionated Accelerated Radiotherapy (HART) with maintenance chemotherapy for metastatic (M1-3) Medulloblastoma--a safety/feasibility study. In: Radiotherapy & Oncology. 2014 ; Vol. 111, No. 1. pp. 41-6.

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@article{20ae121b70d54063b3b21b586b46bcce,
title = "Hyperfractionated Accelerated Radiotherapy (HART) with maintenance chemotherapy for metastatic (M1-3) Medulloblastoma--a safety/feasibility study",
abstract = "BACKGROUND AND PURPOSE: To evaluate feasibility and toxicity of Hyperfractionated Accelerated Radiotherapy (HART) 1.24Gy b.i.d. followed by chemotherapy for M1-3 Medulloblastoma (MB). The aim of HART was to use hyperfractionation to improve therapeutic ratio combined with acceleration to minimise tumour cell repopulation during radiotherapy (RT).MATERIALS AND METHODS: Between February 2002 and May 2008, 34 eligible patients (22 male, 12 female) aged 3-15years (median 7) with metastatic MB (M1-9; M2-3, M3-22) received HART with a craniospinal radiotherapy (CSRT) dose of 39.68Gy followed by 22.32Gy boost to the whole posterior fossa and 9.92Gy metastatic boosts. The 8th and subsequent patients received vincristine (VCR) 1.5mg/m(2) weekly×8 doses over 8weeks starting during the 1st week of RT. Maintenance chemotherapy comprised 8 six-weekly cycles of VCR 1.5mg/m(2) weekly×3, CCNU 75mg/m(2) and cisplatin 70mg/m(2).RESULTS: Median duration of HART was 34days (range 31-38). Grade 3-4 toxicities included mucositis (8), nausea (10), anaemia (5), thrombocytopaenia (2), leucopaenia (24). With 4.5-year median follow-up, 3-year EFS and OS were 59% and 71%, respectively. Of 10 relapses, 1 was outside the central nervous system (CNS), 1 posterior fossa alone and 8 leptomeningeal with 3 also associated with posterior fossa.CONCLUSION: HART with or without VCR was well tolerated and may have a place in the multi-modality management of high-risk MB.",
keywords = "Adolescent, Antineoplastic Combined Chemotherapy Protocols, Cerebellar Neoplasms, Chemoradiotherapy, Chemotherapy, Adjuvant, Child, Child, Preschool, Cisplatin, Dose Fractionation, Feasibility Studies, Female, Humans, Infant, Lomustine, Maintenance Chemotherapy, Male, Medulloblastoma, Neoplasm Metastasis, Neoplasm Recurrence, Local, Radiotherapy Dosage, Survival Rate, Vincristine",
author = "Taylor, {Roger E} and Howman, {Andrew J} and Keith Wheatley and Brogden, {Elena E} and Bridget Large and Gibson, {Michael J} and Keith Robson and Dipayan Mitra and Frank Saran and Antony Michalski and Pizer, {Barry L}",
note = "Copyright {\textcopyright} 2014 Elsevier Ireland Ltd. All rights reserved.",
year = "2014",
month = apr
doi = "10.1016/j.radonc.2014.01.022",
language = "English",
volume = "111",
pages = "41--6",
journal = "Radiotherapy & Oncology",
issn = "0167-8140",
publisher = "Elsevier",
number = "1",

}

RIS

TY - JOUR

T1 - Hyperfractionated Accelerated Radiotherapy (HART) with maintenance chemotherapy for metastatic (M1-3) Medulloblastoma--a safety/feasibility study

AU - Taylor, Roger E

AU - Howman, Andrew J

AU - Wheatley, Keith

AU - Brogden, Elena E

AU - Large, Bridget

AU - Gibson, Michael J

AU - Robson, Keith

AU - Mitra, Dipayan

AU - Saran, Frank

AU - Michalski, Antony

AU - Pizer, Barry L

N1 - Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

PY - 2014/4

Y1 - 2014/4

N2 - BACKGROUND AND PURPOSE: To evaluate feasibility and toxicity of Hyperfractionated Accelerated Radiotherapy (HART) 1.24Gy b.i.d. followed by chemotherapy for M1-3 Medulloblastoma (MB). The aim of HART was to use hyperfractionation to improve therapeutic ratio combined with acceleration to minimise tumour cell repopulation during radiotherapy (RT).MATERIALS AND METHODS: Between February 2002 and May 2008, 34 eligible patients (22 male, 12 female) aged 3-15years (median 7) with metastatic MB (M1-9; M2-3, M3-22) received HART with a craniospinal radiotherapy (CSRT) dose of 39.68Gy followed by 22.32Gy boost to the whole posterior fossa and 9.92Gy metastatic boosts. The 8th and subsequent patients received vincristine (VCR) 1.5mg/m(2) weekly×8 doses over 8weeks starting during the 1st week of RT. Maintenance chemotherapy comprised 8 six-weekly cycles of VCR 1.5mg/m(2) weekly×3, CCNU 75mg/m(2) and cisplatin 70mg/m(2).RESULTS: Median duration of HART was 34days (range 31-38). Grade 3-4 toxicities included mucositis (8), nausea (10), anaemia (5), thrombocytopaenia (2), leucopaenia (24). With 4.5-year median follow-up, 3-year EFS and OS were 59% and 71%, respectively. Of 10 relapses, 1 was outside the central nervous system (CNS), 1 posterior fossa alone and 8 leptomeningeal with 3 also associated with posterior fossa.CONCLUSION: HART with or without VCR was well tolerated and may have a place in the multi-modality management of high-risk MB.

AB - BACKGROUND AND PURPOSE: To evaluate feasibility and toxicity of Hyperfractionated Accelerated Radiotherapy (HART) 1.24Gy b.i.d. followed by chemotherapy for M1-3 Medulloblastoma (MB). The aim of HART was to use hyperfractionation to improve therapeutic ratio combined with acceleration to minimise tumour cell repopulation during radiotherapy (RT).MATERIALS AND METHODS: Between February 2002 and May 2008, 34 eligible patients (22 male, 12 female) aged 3-15years (median 7) with metastatic MB (M1-9; M2-3, M3-22) received HART with a craniospinal radiotherapy (CSRT) dose of 39.68Gy followed by 22.32Gy boost to the whole posterior fossa and 9.92Gy metastatic boosts. The 8th and subsequent patients received vincristine (VCR) 1.5mg/m(2) weekly×8 doses over 8weeks starting during the 1st week of RT. Maintenance chemotherapy comprised 8 six-weekly cycles of VCR 1.5mg/m(2) weekly×3, CCNU 75mg/m(2) and cisplatin 70mg/m(2).RESULTS: Median duration of HART was 34days (range 31-38). Grade 3-4 toxicities included mucositis (8), nausea (10), anaemia (5), thrombocytopaenia (2), leucopaenia (24). With 4.5-year median follow-up, 3-year EFS and OS were 59% and 71%, respectively. Of 10 relapses, 1 was outside the central nervous system (CNS), 1 posterior fossa alone and 8 leptomeningeal with 3 also associated with posterior fossa.CONCLUSION: HART with or without VCR was well tolerated and may have a place in the multi-modality management of high-risk MB.

KW - Adolescent

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Cerebellar Neoplasms

KW - Chemoradiotherapy

KW - Chemotherapy, Adjuvant

KW - Child

KW - Child, Preschool

KW - Cisplatin

KW - Dose Fractionation

KW - Feasibility Studies

KW - Female

KW - Humans

KW - Infant

KW - Lomustine

KW - Maintenance Chemotherapy

KW - Male

KW - Medulloblastoma

KW - Neoplasm Metastasis

KW - Neoplasm Recurrence, Local

KW - Radiotherapy Dosage

KW - Survival Rate

KW - Vincristine

U2 - 10.1016/j.radonc.2014.01.022

DO - 10.1016/j.radonc.2014.01.022

M3 - Article

C2 - 24630538

VL - 111

SP - 41

EP - 46

JO - Radiotherapy & Oncology

JF - Radiotherapy & Oncology

SN - 0167-8140

IS - 1

ER -