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Clinical Trial
. 2021 May;68(5):e28925.
doi: 10.1002/pbc.28925. Epub 2021 Feb 3.

Safety and efficacy of concurrent carboplatin during full-dose craniospinal irradiation for high-risk/metastatic medulloblastoma in a resource-limited setting

Tejpal Gupta  1 , Shwetabh Sinha  1 , Girish Chinnaswamy  2 , Tushar Vora  2 , Maya Prasad  2 , Vasudev Bhat  2 , Jayant Sastri Goda  1 , Rahul Krishnatry  1 , Abhishek Chatterjee  1 , Sridhar Epari  3 , Ayushi Sahay  3 , Aliasgar Moiyadi  4 , Prakash Shetty  4 , Vijay Patil  5 , Soumen Khatua  6 , Rakesh Jalali  7 , Purna Kurkure  2
Affiliations
Clinical Trial

Safety and efficacy of concurrent carboplatin during full-dose craniospinal irradiation for high-risk/metastatic medulloblastoma in a resource-limited setting

Tejpal Gupta et al. Pediatr Blood Cancer. 2021 May.

Abstract

Purpose: To assess the safety and efficacy of concurrent carboplatin during craniospinal irradiation (CSI) in high-risk/metastatic medulloblastoma defined as either residual tumor >1.5 cm2 or leptomeningeal metastases.

Methods: This single-arm combined prospective (2005-2011) and retrospective (2011-2019) study was undertaken at a tertiary care cancer center in India. Following surgery, patients with newly diagnosed high-risk/metastatic medulloblastoma received concurrent carboplatin (35 mg/m2 ) for 15 days (day 1 to day 15) during CSI plus posterior fossa/tumor bed boost, followed by six cycles of standard adjuvant chemotherapy.

Results: All 97 patients completed their planned course of radiotherapy without interruptions, except for two (2.1%) patients who had brief gaps due to treatment-related toxicity. Grade 3-4 anemia, neutropenia, thrombocytopenia, and febrile neutropenia were seen in four (4.1%), 41 (42.2%) 21 (21.6%), and 18 (18.6%) patients, necessitating packed cell transfusion, granulocyte colony-stimulating factor, and platelet support in five (5.1%), 41 (42.2%), and five (5.1%) patients, respectively, during the concurrent phase. Following myelorecovery, 92 (94.9%) patients completed the planned six cycles of standard adjuvant systemic chemotherapy. There were no treatment-related deaths during the concurrent chemo-radiotherapy phase, while three (3.1%) toxic deaths were ascribed to adjuvant chemotherapy-related complications. At a median follow-up of 82 months, the 5-year Kaplan-Meier estimates of progression-free survival and overall survival were 60.2% and 62.1%, respectively. On univariate analysis, leptomeningeal metastases (M0/M1 vs. M2/M3) and histological subtype (large cell/anaplastic vs. others) emerged as significant prognostic factors for survival.

Conclusion: Addition of concurrent carboplatin to RT as radiosensitizing chemotherapy is a simple and effective way of treatment intensification in high-risk/metastatic medulloblastoma.

Keywords: carboplatin; concurrent; craniospinal irradiation; high risk; leptomeningeal metastases; medulloblastoma.

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References

REFERENCES

    1. Ostrom QT, Cioffi G, Gittleman H, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2012-2016. Neuro Oncol. 2019;21(Suppl 5):v1-v100.
    1. Packer R, Vezina G. Management of and prognosis with medulloblastoma: therapy at a crossroads. Arch Neurol. 2008;65(11):1419-1424.
    1. Bouffet E. Management of high-risk medulloblastoma. Neurochirurgie. 2019;Jun 20:S0028-3770(19)30178-X. https://doi.org/10.1016/j.neuchi.2019.05.007. Online ahead of print (last accessed August 31, 2020).
    1. Massimino M, Biassoni V, Gandola L, et al. Childhood medulloblastoma. Crit Rev Oncol Hematol. 2016;105:35-51.
    1. Zeltzer PM, Boyett JM, Finlay JL, et al. Metastasis stage, adjuvant treatment, and residual tumor are prognostic factors for medulloblastoma in children: conclusions from the Children's Cancer Group 921 randomized phase III study. J Clin Oncol. 1999;17(3):832-845.

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