Abstract
The prognosis of recurrent medulloblastoma remains extremely poor. Combination chemotherapy with cisplatin (CDDP) and etoposide (VP-16) was given to five children with early recurrent medulloblastoma. As a rule, CDDP 20 mg/m2 per day and VP-16 60 mg/m2 per day were administered intravenously for 5 days. This cycle was repeated three times at 4-week intervals. After this therapy, cerebellar signs improved in one case and were unchanged in four cases. Weakness and sensory disturbance, however, improved in three of four patients. Moreover, neck and/or back pain resolved in all these four. Radiological findings improved in three cases. Myelosuppression appeared in all patients, but receded rapidly. No other significant complications were noticed. Two patients died 5 and 6 months after this therapy. There results seem to suggest that this therapy has a use in improving neurological symptoms, particularly neck and/or back pain, although its efficacy is limited.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Allen JC, Helson L (1981) High-dose cyclophosphamide chemotherapy for recurrent CNS tumors in children. J Neurosurg 55:749–756
Chang CH, Housepian EM, Herbert C Jr (1969) An operative staging system and a megavoltage radiotherapeutic technique for cerebellar medulloblastomas. Radiology 93:1351–1359
Cohen ME, Duffner PK (1984) Medulloblastoma. In: Cohen ME (ed) Brain tumors in children. Principles of diagnosis and treatment. Raven Press, New York, pp 103–119
Friedman HS, Mahaley MS Jr, Schold SC Jr, Vick NA, Falletta JM, Bullard DE, D'Souza BJ, Khandekar JD, Lew S, Oakes WJ, Bigner DD (1986) Efficacy of vincristine and cyclophosphamide in the therapy of recurrent medulloblastoma. Neurosurgery 18:335–340
Grieder A, Maurer R, Stahelin H (1974) Effect of an epipodophyllotoxin derivative (VP 16-213) on macromolecular synthesis and mitosis in mastocytoma cells in vitro. Cancer Res 34:1788–1793
Hellman RM, Calogero JA, Kaplan BM (1990) VP-16, vincristine and procarbazine with radiation therapy for treatment of malignant brain tumors. J Neurooncol 8:163–166
Issell BF (1982) The podophyllotoxin derivatives VP-16-213 and VM26. Cancer Chemother Pharmacol 7:73–80
Issell BF, Crooke T (1979) Etoposide (VP-16-213). Cancer Treat Rev 6:107–124
Kalwinsky DK, Look AT, Ducore J, Fridland A (1983) Effects of the epipodophyllotoxin VP-16-213 on cell cycle traverse, DNA synthesis, and DNA strand size in cultures of human leukemic lymphoblasts. Cancer Res 43:1592–1597
Kobayashi T, Yoshida J, Ishiyama J, Noda S, Kito A, Kida Y (1989) Combination chemotherapy with cisplatin and etoposide for malignant intracranial germ-cell tumors. J Neurosurg 70:676–681
Lefkowitz IB, Packer RJ, Siegel KR, Sutton LN, Schut L, Evans AE (1990) Results of treatment of children with recurrent medulloblastoma/primitive neuroectodermal tumors with lomustine, cisplatin, and vincristine. Cancer 65:412–417
Sexauer CL, Khan A, Burger PC, Krischer JP, Eys JV, Vats T, Ragab AH (1985) Cisplatin in recurrent pediatric brain tumors. A POG phase II study. Cancer 56:1497–1501
Thomas PRM, Duffner PK, Cohen ME, Sinks LF, Tebbi C, Freeman AI (1980) Multimodality therapy for medulloblastoma. Cancer 45:666–669
Walker RW, Allen JC (1983) Treatment of recurrent primary intracranial childhood tumors with cis-diammine-dichloroplatinum. Ann Neurol 14:371–372
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kudo, H., Kokunai, T., Kuwamura, K. et al. Treatment of early recurrent medulloblastoma in children with cisplatin and etoposide: a preliminary report. Child's Nerv Syst 8, 133–135 (1992). https://doi.org/10.1007/BF00298268
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00298268