Korean J Pediatr Hematol Oncol.  1998 Apr;5(1):106-112.

A Result of Treatment of 'Eight Drugs in a Day' in Medulloblastoma: Comparison between Pre- vs Post-Irradiation Chemotherapy

• Kang HJ
• Lee JA
• Han HJ
• Yoo ES
• Choi HS
• Shin HY
• Yang SW
• Cho BK
• Kim CW
• Kim IH
• Kim IW
• Ahn HS

Abstract

BACKGROUND: 'Eight drugs in a day' was one of the widely used regimen in medulloblastoma. Result of treatment of this regimen and comparison between pre-RT chemotherapy and post-RT chemotherapy were presented.
METHODS
Medical records of children who were diagnosed as medulloblastoma and treated with 8 in 1 therapy in Seoul National University Children's Hospital from January 1986 to June 1997 were reviewed.
RESULTS
1) Forty nine cases(male: 30, female: 19) were analyzed. The age at diagnosis was between 3 months and 15 years 3 months and median age was 7 years 10 months. 2) The T stage by Chang classification revealed T1(2%), T2(26%), T3a(9%), T3b(56%), and T4(7%) in 43 cases. M stage revealed M0(46%), M1(15%), M3(37%), and M4(2%) in 41 cases. The surgical results revealed gross total resection(36%), near total resection(18%), subtotal resection(38%), and partial resection(9%). 3) The 5-yr disease free survival(DFS) rate of all tumors was 53%. There was no difference in DFS about sex, age, pathology, T stage, M stage, and surgical result. 4) Difference of 5-year DFS between pre-RT chemotherapy group(53%) and post-RT chemotherapy group(83%) was significant[-2Log(LR), P=0.023], excluding the patient relapsed or too young(below 18 month, who had more chemotherapy to delay radiation) to be received radiation therapy.
CONCLUSIONS
DFS in post-RT chemotherapy was better than pre-RT chemotherapy. As medulloblastoma has the property to confine in CNS system, prior treatment with radiation as a intensive local therapy may be more effective than the systemic chemotherapy. Progression or relapse were the main causes of treatment failure. Result of treatment may be improved by more intensive therapy.

Keyword

Medulloblastoma; 8 in 1; Pre-radiation chemotherapy; Post-radiation chemotherapy

MeSH Terms

Child
Classification
Diagnosis
Drug Therapy*
Female
Humans
Medical Records
Medulloblastoma*
Pathology
Recurrence
Seoul
Treatment Failure