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A European randomis...
A European randomised controlled trial of the addition of etoposide to standard vincristine and carboplatin induction as part of an 18-month treatment programme for childhood (≤16 years) low grade glioma - A final report.
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- Gnekow, Astrid K (författare)
- Swabian Children's Cancer Center, Klinikum Augsburg, Germany
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- Walker, David A (författare)
- Children's Brain Tumour Research Centre, University of Nottingham, UK
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- Kandels, Daniela (författare)
- Children's Brain Tumour Research Centre, University of Nottingham, UK
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- Picton, Susan (författare)
- Leeds Children's Hospital, UK
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- Perilongo, Giorgio (författare)
- Division of Pediatrics, University Hospital of Padua, Italy
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- Grill, Jacques (författare)
- Institut Gustave Roussy, Paris, France
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- Stokland, Tore (författare)
- University Hospital of North Norway, Norway
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- Sandström, Per Eric (författare)
- Umeå universitet,Pediatrik,Umea University, Sweden
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- Warmuth-Metz, Monika (författare)
- Department of Neuro-radiology, University of Wurzberg, Germany
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- Pietsch, Torsten (författare)
- University of Bonn Medical Centre, Germany
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- Giangaspero, Felice (författare)
- Department of Radiological, Oncological and Anatomo-pathological Sciences, University Sapienza Rome, Italy
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- Schmidt, René (författare)
- Institute of Biostatistics and Clinical Research, University of Muenster, Germany
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- Faldum, Andreas (författare)
- Institute of Biostatistics and Clinical Research, University of Muenster, Germany
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- Kilmartin, Denise (författare)
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
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- De Paoli, Angela (författare)
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
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- De Salvo, Gian Luca (författare)
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
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(creator_code:org_t)
- Elsevier BV, 2017
- 2017
- Engelska.
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 81, s. 206-225
- Relaterad länk:
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http://www.ejcancer....
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- BACKGROUND: The use of chemotherapy to manage newly diagnosed low grade glioma (LGG) was first introduced in the 1980s. One randomised trial has studied two- versus four-drug regimens with a duration of 12 months of treatment after resection.METHODS: Within the European comprehensive treatment strategy for childhood LGG, the International Society of Paediatric Oncology-Low Grade Glioma (SIOP LGG) Committee launched a randomised trial involving 118 institutions and 11 countries to investigate the addition of etoposide (100 mg/m2, days 1, 2 & 3) to a four-course induction of vincristine (1.5 mg/m2 × 10 wkly) and carboplatin (550 mg/m2 q 3 weekly) as part of 18-month continuing treatment programme. Patients were recruited after imaging diagnosis, resection or biopsy with progressive disease/symptoms. Some 497 newly diagnosed patients (M/F 231/266; median age 4.26 years (interquartile range (IQR) 2.02-7.06)) were randomised to receive vincristine carboplatin (VC) (n = 249) or VC plus etoposide (VCE) during induction (n = 248), stratified by age and tumour site.FINDINGS: No differences between the two arms were found in term of survival and radiological response. Response and non-progression rates at 24 weeks for VC and VCE, were 46% versus 41%, and 93% versus 91% respectively; 5-year Progression-Free Survival (PFS) and Overall Survival (OS) were 46% (StDev 3.5) versus 45% (StDev 3.5) and 89% (StDev 2.1) versus 89% (StDev 2.1) respectively. Age and diencephalic syndrome are adverse clinical risk factors for PFS and OS. 5-year OS for patients in early progression at week 24 were 46% (StDev 13.8) and 49% (StDev 16.5) in the two arms, respectively.INTERPRETATION: The addition of etoposide to VC did not improve PFS or OS. High non-progression rates at 24 weeks justify retaining VC as standard first-line therapy. Infants with diencephalic syndrome and early progression need new treatments to be tested. Future trials should use neurological/visual and toxicity outcomes and be designed to discriminate between the impact on disease outcomes of 'duration of therapy' and 'age at stopping therapy'.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Nyckelord
- Chemotherapy
- Childhood
- Low grade glioma
- Randomised trial
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Gnekow, Astrid K
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Walker, David A
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Kandels, Daniela
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Picton, Susan
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Perilongo, Giorg ...
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Grill, Jacques
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Stokland, Tore
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Sandström, Per E ...
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Warmuth-Metz, Mo ...
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Pietsch, Torsten
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Giangaspero, Fel ...
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Schmidt, René
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Faldum, Andreas
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Kilmartin, Denis ...
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De Paoli, Angela
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De Salvo, Gian L ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Cancer och onkol ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Pediatrik
- Artiklar i publikationen
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European Journal ...
- Av lärosätet
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Uppsala universitet
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Umeå universitet