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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)
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Walker, David A. (författare)
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Kandels, Daniela (författare)
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visa fler...
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Picton, Susan (författare)
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Perilongo, Giorgio (författare)
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Grill, Jacques (författare)
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Stokland, Tore (författare)
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Sandström, Per Eric (författare)
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Warmuth-Metz, Monika (författare)
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Pietsch, Torsten (författare)
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Giangaspero, Felice (författare)
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Schmidt, Rene (författare)
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Faldum, Andreas (författare)
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Kilmartin, Denise (författare)
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De Paoli, Angela (författare)
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De Salvo, Gian Luca (författare)
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visa färre...
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(utgivare)
- Elsevier 2017
- 2017
- Engelska.
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Ingår i: European Journal of Cancer. - 0959-8049. ; 81, 206-225
Abstract
Ämnesord
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- 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 OncologyeLow Grade Glioma (SIOP LGG) Committee launched a randomised trial involving 118 institutions and 11 countries to investigate the addition of etoposide (100 mg/m(2), days 1, 2 & 3) to a four-course induction of vincristine (1.5 mg/m(2) x 10 wkly) and carboplatin (550 mg/m(2) 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
- Medical and Health Sciences (hsv)
- Clinical Medicine (hsv)
- Cancer and Oncology (hsv)
- Medicin och hälsovetenskap (hsv)
- Klinisk medicin (hsv)
- Cancer och onkologi (hsv)
- Medical and Health Sciences (hsv)
- Clinical Medicine (hsv)
- Pediatrics (hsv)
- Medicin och hälsovetenskap (hsv)
- Klinisk medicin (hsv)
- Pediatrik (hsv)
Nyckelord
- Low grade glioma
- Childhood
- Chemotherapy
- Randomised trial
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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 ...
-
Grill, Jacques
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visa fler...
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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, Rene
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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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visa färre...
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