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- Title
Nonrandomized comparison of neurofibromatosis type 1 and non-neurofibromatosis type 1 children who received carboplatin and vincristine for progressive low-grade glioma: A report from the Children's Oncology Group.
- Authors
Ater, Joann L.; Xia, Caihong; Mazewski, Claire M.; Booth, Timothy N.; Freyer, David R.; Packer, Roger J.; Sposto, Richard; Vezina, Gilbert; Pollack, Ian F.
- Abstract
<bold>Background: </bold>To evaluate tumor responses, event-free survival (EFS), overall survival (OS), and toxicity of chemotherapy, children with neurofibromatosis type 1 (NF1) and progressive low-grade glioma were enrolled into the Children's Oncology Group (COG) A9952 protocol and treated with carboplatin and vincristine (CV).<bold>Methods: </bold>Non-NF1 patients were randomized to CV or thioguanine, procarbazine, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea, and vincristine in COG A9952. NF1 patients were assigned to CV only. NF1 patients and non-NF1 patients who were treated with CV were compared with respect to baseline characteristics, toxicity, tumor responses, EFS, and OS.<bold>Results: </bold>A total of 127 eligible patients with NF1 were nonrandomly assigned to CV: 42 NF1 patients (33%) had events, and 6 (4.7%) died. The 5-year EFS rate was 69% ± 4% for the CV-NF1 group and 39% ± 4% for the CV-non-NF1 group (P < .001). In a univariate analysis, NF1 children had a significantly higher tumor response rate and superior EFS and OS in comparison with CV-treated children without NF1. NF1 patients and non-NF1 patients differed significantly in amount of residual tumor, extent of resection, tumor location, and pathology. According to a multivariate analysis, NF1 was independently associated with better EFS (P < .001) but not with OS. NF1 patients also had a decreased risk of grade 3 or 4 toxicities in comparison with non-NF1 patients. Three second malignant neoplasms occurred in NF1 patients receiving CV (CV-NF1 group) at a median of 7.8 years (range, 7.3-9.4 years) after enrollment, but there were none in the non-NF1 group.<bold>Conclusions: </bold>Children with NF1 tolerated CV well and had tumor response rates and EFS that were superior to those for children without NF1. Cancer 2016;122:1928-36. © 2016 American Cancer Society.
- Subjects
NEUROFIBROMATOSIS 1; NEUROFIBROMATOSIS 2; CARBOPLATIN; VINCRISTINE; NEUROFIBROMATOSIS in children; GLIOMAS; THERAPEUTICS; ANTINEOPLASTIC agents; BENZAMIDE; BRAIN tumors; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; PURINES; RESEARCH; EVALUATION research; RANDOMIZED controlled trials; DISEASE complications
- Publication
Cancer (0008543X), 2016, Vol 122, Issue 12, p1928
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.29987