Radiation Therapy Plus Combination Chemotherapy in Treating Children With Medulloblastoma
RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving radiation therapy in different ways with combination chemotherapy may kill any remaining tumor cells following surgery. It is not yet known which radiation therapy regimen combined with combination chemotherapy is more effective in treating medulloblastoma.
PURPOSE: Randomized phase III trial to compare different radiation therapy regimens plus combination chemotherapy in treating children who have undergone surgery for medulloblastoma.
Brain and Central Nervous System Tumors
Drug: vincristine sulfate
Procedure: adjuvant therapy
Radiation: radiation therapy
|Study Design:||Allocation: Randomized
Primary Purpose: Treatment
|Official Title:||A Prospective Randomised Controlled Trial Of Hyperfractionated Versus Conventionally Fractionated Radiotherapy In Standard Risk Medulloblastoma|
- Comparison of event-free survival at 3 years
- Comparison of overall survival
- Comparison of the pattern of relapse (i.e., local relapse [tumor bed and posterior fossa outside tumor bed])
- Comparison of late sequelae, in terms of health status, quality of life, hearing loss, and endocrine deficiencies
- Toxicity of neurosurgery
|Study Start Date:||February 2003|
- Compare the event-free survival rate in pediatric patients with standard-risk medulloblastoma treated with conventional vs hyperfractionated radiotherapy and vincristine followed by maintenance with cisplatin, lomustine, and vincristine.
- Compare the overall survival of patients treated with these regimens.
- Compare the pattern of relapse, especially local relapse (tumor bed or posterior fossa outside tumor bed), in patients treated with these regimens.
- Determine the toxicity of surgery and whether there are identifiable factors that correlate with toxicity in these patients.
- Determine the impact of any surgical complications on commencement of adjuvant therapy and event-free survival of these patients.
- Compare late sequelae, in terms of health status, endocrine deficiencies, and hearing loss, in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to country. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Within 28-40 days after surgical resection, patients undergo conventional fractionated radiotherapy once daily, 5 days a week, for 6-7 weeks. Patients also receive vincristine IV once weekly for 8 weeks.
- Arm II: Beginning as in arm I, patients undergo hyperfractionated radiotherapy twice daily, 5 days a week, for 6-7 weeks. Patients also receive vincristine as in arm I.
- Maintenance chemotherapy:Six weeks after completion of radiotherapy, all patients receive cisplatin IV over 6 hours and oral lomustine on day 1 and vincristine IV on days 1, 8, and 15. Treatment repeats every 6 weeks for 8 courses.
Patients are followed at least every 6 months for 3 years.
Peer Reviewed and Funded or Endorsed by Cancer Research UK
PROJECTED ACCRUAL: A total of 316 patients (158 per treatment arm) will be accrued for this study within 4 years.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00053872
|Leuven, Belgium, B-3000|
|Institut Curie Hopital|
|Paris, France, 75248|
|Universitaets - Kinderklinik Wuerzburg|
|Wuerzburg, Germany, D-97080|
|Ospedale Infantile Regina Margherita|
|Turin, Italy, 10126|
|Academisch Medisch Centrum at University of Amsterdam|
|Amsterdam, Netherlands, 1105 AZ|
|Hospital de Cruces|
|Vizcaya, Spain, 48|
|Gothenburg, Sweden, 41685|
|Royal Liverpool Children's Hospital, Alder Hey|
|Liverpool, England, United Kingdom, L12 2AP|
|Study Chair:||Brigitta Lannering, MD, PhD||Ostra Sjukhuset|