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ANZCCSG BabyBrain99; intensified systemic chemotherapy, second look surgery and involved field radiation in young children with central nervous system malignancy

Bandopadhayay, Pratiti, Hassall, Timothy E., Rosenfeld, Jeffrey V., Wheeler, Greg C., Downie, Peter A., Kirby, Maria L., Cohn, Richard J., Sullivan, Michael J. and Ashley, David M. 2011, ANZCCSG BabyBrain99; intensified systemic chemotherapy, second look surgery and involved field radiation in young children with central nervous system malignancy, Pediatric blood and cancer, vol. 56, no. 7, pp. 1055-1061, doi: 10.1002/pbc.22942.

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Title ANZCCSG BabyBrain99; intensified systemic chemotherapy, second look surgery and involved field radiation in young children with central nervous system malignancy
Author(s) Bandopadhayay, Pratiti
Hassall, Timothy E.
Rosenfeld, Jeffrey V.
Wheeler, Greg C.
Downie, Peter A.
Kirby, Maria L.
Cohn, Richard J.
Sullivan, Michael J.
Ashley, David M.
Journal name Pediatric blood and cancer
Volume number 56
Issue number 7
Start page 1055
End page 1061
Total pages 7
Publisher Wiley
Place of publication Hoboken, N.J.
Publication date 2011-07-01
ISSN 1545-5017
Keyword(s) Antineoplastic Combined Chemotherapy Protocols
Brain Neoplasms
Carboplatin
Child, Preschool
Cisplatin
Combined Modality Therapy
Cyclophosphamide
Etoposide
Feasibility Studies
Female
Follow-Up Studies
Glioma
Humans
Infant
Male
Melphalan
Radiotherapy Dosage
Remission Induction
Second-Look Surgery
Spinal Neoplasms
Stem Cell Transplantation
Survival Rate
Transplantation, Autologous
Treatment Outcome
Vincristine
Science & Technology
Life Sciences & Biomedicine
Oncology
Hematology
Pediatrics
brain tumours
chemotherapy
infants
irradiation
Summary BACKGROUND: ANZCCSG BabyBrain99 is a trial of intensive systemic chemotherapy with dual stem cell supported treatment, second look surgery and involved field radiation for children less than four years of age with malignant central nervous system tumours.
PROCEDURE: Following primary resection, treatment included two courses of cisplatin and oral etoposide, a third course of mobilising chemotherapy (vincristine, etoposide, cyclophosphamide) with stem cell harvest, followed by intensive stem cell supported chemotherapy with high dose cyclophosphamide, etoposide and vincristine. Children were evaluated for second resection before proceeding to a second stem cell supported consolidation therapy consisting of melphalan and carboplatin. Patients then received involved field radiation therapy.
RESULTS: Thirty three children with a range of diagnoses were enrolled. Nine percent of children had metastatic disease at diagnosis. Eighteen children completed treatment including irradiation. At the end of induction the event free survival was 70% (54-86). Forty eight percent of children had a complete response, 18% had stable disease and 3% had a partial response. Five year overall survival was 40% (22-56) and event free survival was 33% (17-50). Children in whom a complete resection were achieved had a significantly superior outcome compared to those children without a complete resection, 5 year EFS 60% (45-75), as compared to 22% (13-30), P-value <0.05.
CONCLUSIONS: BabyBrain99 confirms that intensive stem cell supported chemotherapy can be safely administered to infants with CNS tumours however overall prognosis remains poor. Importantly, the study reinforces a complete surgical resection as an important favourable prognostic indicator.
Notes This work has been presented (oral presentation) in part at the 13th International Symposium on Pediatric Neuro-Oncology in 2008 and the Australian/New Zealand Children's Hematology Oncology Group ASM in 2009.
Language eng
DOI 10.1002/pbc.22942
Field of Research 111403 Paediatrics
111205 Chemotherapy
111208 Radiation Therapy
110323 Surgery
110903 Central Nervous System
1112 Oncology And Carcinogenesis
1114 Paediatrics And Reproductive Medicine
Socio Economic Objective 920102 Cancer and Related Disorders
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2011, Wiley-Liss, Inc.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30068988

Document type: Journal Article
Collection: School of Medicine
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