PMID- 22665535
OWN - NLM
STAT- MEDLINE
DCOM- 20120924
LR  - 20220409
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 30
IP  - 21
DP  - 2012 Jul 20
TI  - Randomized study of two chemotherapy regimens for treatment of low-grade glioma 
      in young children: a report from the Children's Oncology Group.
PG  - 2641-7
LID - 10.1200/JCO.2011.36.6054 [doi]
AB  - PURPOSE Surgery is curative therapy for pediatric low-grade gliomas (LGGs) in 
      areas of the brain amenable to complete resection. However, LGGs located in areas 
      where complete resection is not possible can threaten both function and life. The 
      purpose of this study was to compare two chemotherapy regimens for LGGs in 
      children younger than age 10 years for whom radiotherapy was felt by the 
      practitioner to pose a high risk of neurodevelopmental injury. PATIENTS AND 
      METHODS Previously untreated children younger than age 10 years with progressive 
      or residual LGGs were eligible. Children were randomly assigned to receive 
      carboplatin and vincristine (CV) or thioguanine, procarbazine, lomustine, and 
      vincristine (TPCV). Children with neurofibromatosis are reported separately. 
      Results Of 274 randomly assigned patients who met eligibility requirements, 137 
      received CV and 137 received TPCV. The 5-year event-free survival (EFS) and 
      overall survival (OS) rates for all eligible patients were 45% +/- 3.2% and 86% +/- 
      2.2%, respectively. The 5-year EFS rates were 39% +/- 4% for CV and 52% +/- 5% for 
      TPCV (stratified log-rank test P = .10; cure model analysis P = .007). On 
      multivariate analysis, factors independently predictive of worse EFS and OS were 
      younger age and tumor size greater than 3 cm(2). Tumor location in the thalamus 
      was also associated with poor OS. CONCLUSION The difference in EFS between the 
      regimens did not reach significance on the basis of the stratified log-rank test. 
      The 5-year EFS was higher for TPCV on the basis of the cure model analysis. 
      Differences in toxicity may influence physician choice of regimens.
FAU - Ater, Joann L
AU  - Ater JL
AD  - Division of Pediatrics, University of Texas MD Anderson Cancer Center, 1515 
      Holcombe Blvd, Houston, TX 77030, USA. jater@mdanderson.org
FAU - Zhou, Tianni
AU  - Zhou T
FAU - Holmes, Emiko
AU  - Holmes E
FAU - Mazewski, Claire M
AU  - Mazewski CM
FAU - Booth, Timothy N
AU  - Booth TN
FAU - Freyer, David R
AU  - Freyer DR
FAU - Lazarus, Ken H
AU  - Lazarus KH
FAU - Packer, Roger J
AU  - Packer RJ
FAU - Prados, Michael
AU  - Prados M
FAU - Sposto, Richard
AU  - Sposto R
FAU - Vezina, Gilbert
AU  - Vezina G
FAU - Wisoff, Jeffrey H
AU  - Wisoff JH
FAU - Pollack, Ian F
AU  - Pollack IF
LA  - eng
GR  - U10 CA098543/CA/NCI NIH HHS/United States
GR  - U10 CA98543/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20120604
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 35S93Y190K (Procarbazine)
RN  - 5J49Q6B70F (Vincristine)
RN  - 7BRF0Z81KG (Lomustine)
RN  - BG3F62OND5 (Carboplatin)
RN  - FTK8U1GZNX (Thioguanine)
SB  - IM
CIN - J Clin Oncol. 2012 Dec 20;30(36):4583; author reply 4583-4. PMID: 23150699
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Brain Neoplasms/drug therapy
MH  - Carboplatin/administration & dosage
MH  - Central Nervous System Neoplasms/*drug therapy/pathology
MH  - Child
MH  - Child, Preschool
MH  - Drug Administration Schedule
MH  - Female
MH  - Glioma/*drug therapy/pathology
MH  - Humans
MH  - Infant
MH  - Lomustine/administration & dosage
MH  - Male
MH  - Multivariate Analysis
MH  - Procarbazine/administration & dosage
MH  - Prognosis
MH  - Risk Factors
MH  - Spinal Cord Neoplasms/drug therapy
MH  - Thioguanine/administration & dosage
MH  - Treatment Outcome
MH  - Vincristine/administration & dosage
PMC - PMC3413276
COIS- Authors' disclosures of potential conflicts of interest and author contributions 
      are found at the end of this article.
EDAT- 2012/06/06 06:00
MHDA- 2012/09/25 06:00
PMCR- 2013/07/20
CRDT- 2012/06/06 06:00
PHST- 2012/06/06 06:00 [entrez]
PHST- 2012/06/06 06:00 [pubmed]
PHST- 2012/09/25 06:00 [medline]
PHST- 2013/07/20 00:00 [pmc-release]
AID - JCO.2011.36.6054 [pii]
AID - 66054 [pii]
AID - 10.1200/JCO.2011.36.6054 [doi]
PST - ppublish
SO  - J Clin Oncol. 2012 Jul 20;30(21):2641-7. doi: 10.1200/JCO.2011.36.6054. Epub 2012 
      Jun 4.