Document Detail


Progression-free survival in children with optic pathway tumors: dependence on age and the quality of the response to chemotherapy--results of the first French prospective study for the French Society of Pediatric Oncology.
MedLine Citation:
PMID:  14673044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate a strategy aimed at avoiding radiotherapy during first-line treatment of children with progressive optic pathway tumors (OPT), by exclusively administering multiagent chemotherapy during 16 months. PATIENTS AND METHODS: Between 1990 and 1998, 85 children with progressive OPT were enrolled onto this multicenter nationwide trial. Chemotherapy alternating procarbazine plus carboplatin, etoposide plus cisplatin, and vincristine plus cyclophosphamide was given every 3 weeks. At the time of relapse or progression, second-line chemotherapy was authorized before recourse to radiotherapy. RESULTS: Objective response rate (partial response [PR] + complete response [CR]) to chemotherapy was 42%. Five-year progression-free survival (PFS) and overall survival rates were 34% and 89%, respectively. The 5-year radiotherapy-free survival rate was 61%. In the multivariate analysis of the 85 patients that entered onto the study, factors associated with the risk of disease progression were age younger than 1 year at diagnosis (P =.047) and absence of neurofibromatosis type 1 (P =.035). In the multivariate analysis of the 74 patients that remained on study after the first cycle of chemotherapy, factors associated with the risk of disease progression were age younger than 1 year at diagnosis (P =.0053) and no objective response to chemotherapy (P =.0029). Three-year PFS was 44% in infants < or = 1 year versus 66% in children older than 1 year. Three-year PFS was 53% in the absence of an objective response to chemotherapy versus 68% after a PR or CR. CONCLUSION: A significant proportion of children with OPT can avoid radiotherapy after prolonged chemotherapy. Deferring irradiation with chemotherapy protocols did not compromise overall survival of the entire population or visual function.
Authors:
Véronique Laithier; Jacques Grill; Marie-Cécile Le Deley; Marie-Madeleine Ruchoux; Dominique Couanet; François Doz; Fabienne Pichon; Hervé Rubie; Didier Frappaz; Jean-Paul Vannier; Annie Babin-Boilletot; Eric Sariban; Pascal Chastagner; Michel Zerah; Marie-Anne Raquin; Olivier Hartmann; Chantal Kalifa;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  21     ISSN:  0732-183X     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-15     Completed Date:  2004-02-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4572-8     Citation Subset:  IM    
Affiliation:
Department of Pediatric and Adolescent Medicine, Insitut Gustave Roussy, 39, rue Camille Desmoulins, 94805 Villejuif, France.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Chi-Square Distribution
Child
Child, Preschool
Combined Modality Therapy
Disease-Free Survival
Factor Analysis, Statistical
Female
France
Humans
Infant
Infant, Newborn
Male
Optic Nerve Neoplasms / drug therapy*
Prospective Studies
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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