Difference between revisions of "Medulloblastoma - historical"
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| + | =COGACNS0331 Reduced Dose CSRT/Reduced Volume Boost to Tumor Bed= | ||
| + | *Ages 3-7 Randomized | ||
| + | *All patients must begin therapy within 31 days of surgery. | ||
| + | ==Chemoradiotherapy== | ||
| + | ===XRT=== | ||
| + | *Craniospinal [[External beam radiotherapy]] 18 Gy in 10 daily fractions. | ||
| + | *Posterior Fossa [[External beam radiotherapy]] 5.4 Gy in 3 daily fractions prior to the radiation boost. | ||
| + | *Tumor Bed Boost [[External beam radiotherapy]] 30.6 Gy in 17 daily fractions. | ||
| + | |||
| + | ===Chemotherapy=== | ||
| + | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute or IV infusion (per institution) once on day 8, 15, 22, 29, 36, and 43 (Once a week starting one week after CSRT begins). | ||
| + | **Round vincristine '''down''' to the nearest 0.1 mg. | ||
| + | '''7-week course''' | ||
| + | ====References==== | ||
| + | #'''COG ACNS0331:''' Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. [https://doi.org/10.1200/JCO.20.02730 link to original article] NCT00085735 | ||
| + | |||
| + | ==Maintenance Regimen A== | ||
| + | Cycles 1, 2, 4, 5, 7, 8 | ||
| + | ===Chemotherapy=== | ||
| + | *[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV once on day 1 | ||
| + | *[[Lomustine (CCNU)]] 75 mg/m<sup>2</sup> PO once on day 1 on an empty stomach (at least 2 hours after food) preferably at bedtime (reduce N/V). | ||
| + | **[[Pediatric Lomustine Dosing Chart]] | ||
| + | **Give [[Lomustine (CCNU)]] with at least 8 oz of fluids for children > 3 years old and at least 4 oz of fluids for children < 3 years of age. | ||
| + | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1, 8, and 15. | ||
| + | **Dose rounded '''down''' to the nearest 0.1 mg. | ||
| + | **Can be given IV push over 1-minute or by infusion via minibag as per institution policy. | ||
| + | |||
| + | '''6-week cycle''' | ||
| + | |||
| + | ====References==== | ||
| + | #'''COG ACNS0331:''' Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. [https://doi.org/10.1200/JCO.20.02730 link to original article] NCT00085735 | ||
| + | |||
| + | ==Maintenance Regimen B== | ||
| + | Cycles 3, 6, and 9 | ||
| + | ===Chemotherapy=== | ||
| + | *[[Cyclophosphamide (Cytoxan)]] 1000 mg/m<sup>2</sup> IV given over 1 hour on Days 1 and 2. | ||
| + | *[[Mesna (Mesnex)]] 360 mg/m<sup>2</sup>/dose IV over 15 to 30 minutes on Days 1 and 2 | ||
| + | **Dose given at least 15 minutes prior to or at the same time as [[Cyclophosphamide (Cytoxan)]] and repeated at 4 and 8 hours post [[Cyclophosphamide (Cytoxan)]]. | ||
| + | **Can be given via continuous infusion starting 15-30 minutes before or at the same time as [[Cyclophosphamide (Cytoxan)]] and finished no sooner than 8 hours after the end of the [[Cyclophosphamide (Cytoxan)]] infusion. | ||
| + | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1, and 8. | ||
| + | **Dose rounded '''down''' to the nearest 0.1 mg. | ||
| + | **Can be given IV push over 1-minute or by infusion via minibag as per institution policy. | ||
| + | |||
| + | '''6-week course''' | ||
| + | |||
| + | ====References==== | ||
| + | #'''COG ACNS0331:''' Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. [https://doi.org/10.1200/JCO.20.02730 link to original article] NCT00085735 | ||
| + | |||
| + | =COGACNS0331 Reduced Dose CSRT/Standard Volume Boost= | ||
| + | *Ages 3-7 | ||
| + | *All patients must begin therapy within 31 days of surgery. | ||
| + | ==Chemoradiotherapy== | ||
| + | ===XRT=== | ||
| + | *Craniospinal [[External beam radiotherapy]] 18 Gy in 10 daily fractions. | ||
| + | *Posterior Fossa [[External beam radiotherapy]] 5.4 Gy in 3 daily fractions prior to the radiation boost. | ||
| + | *Posterior Fossa Boost [[External beam radiotherapy]] 30.6 Gy in 17 daily fractions. | ||
| + | |||
| + | ===Chemotherapy=== | ||
| + | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute or IV infusion (per institution) once on day 8, 15, 22, 29, 36, and 43 (Once a week starting one week after CSRT begins). | ||
| + | **Round vincristine '''down''' to the nearest 0.1 mg. | ||
| + | '''7-week course''' | ||
| + | ====References==== | ||
| + | #'''COG ACNS0331:''' Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. [https://doi.org/10.1200/JCO.20.02730 link to original article] NCT00085735 | ||
| + | |||
| + | ==Maintenance Regimen A== | ||
| + | Cycles 1, 2, 4, 5, 7, 8 | ||
| + | ===Chemotherapy=== | ||
| + | *[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV once on day 1 | ||
| + | *[[Lomustine (CCNU)]] 75 mg/m<sup>2</sup> PO once on day 1 on an empty stomach (at least 2 hours after food) preferably at bedtime (reduce N/V). | ||
| + | **[[Pediatric Lomustine Dosing Chart]] | ||
| + | **Give [[Lomustine (CCNU)]] with at least 8 oz of fluids for children > 3 years old and at least 4 oz of fluids for children < 3 years of age. | ||
| + | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1, 8, and 15. | ||
| + | **Dose rounded '''down''' to the nearest 0.1 mg. | ||
| + | **Can be given IV push over 1-minute or by infusion via minibag as per institution policy. | ||
| + | |||
| + | '''6-week cycle''' | ||
| + | |||
| + | ====References==== | ||
| + | #'''COG ACNS0331:''' Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. [https://doi.org/10.1200/JCO.20.02730 link to original article] NCT00085735 | ||
| + | |||
| + | |||
| + | ==Maintenance Regimen B== | ||
| + | Cycles 3, 6, and 9 | ||
| + | ===Chemotherapy=== | ||
| + | *[[Cyclophosphamide (Cytoxan)]] 1000 mg/m<sup>2</sup> IV given over 1 hour on Days 1 and 2. | ||
| + | *[[Mesna (Mesnex)]] 360 mg/m<sup>2</sup>/dose IV over 15 to 30 minutes on Days 1 and 2 | ||
| + | **Dose given at least 15 minutes prior to or at the same time as [[Cyclophosphamide (Cytoxan)]] and repeated at 4 and 8 hours post [[Cyclophosphamide (Cytoxan)]]. | ||
| + | **Can be given via continuous infusion starting 15-30 minutes before or at the same time as [[Cyclophosphamide (Cytoxan)]] and finished no sooner than 8 hours after the end of the [[Cyclophosphamide (Cytoxan)]] infusion. | ||
| + | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1, and 8. | ||
| + | **Dose rounded '''down''' to the nearest 0.1 mg. | ||
| + | **Can be given IV push over 1-minute or by infusion via minibag as per institution policy. | ||
| + | |||
| + | '''6-week course''' | ||
| + | |||
| + | ====References==== | ||
| + | #'''COG ACNS0331:''' Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. [https://doi.org/10.1200/JCO.20.02730 link to original article] NCT00085735 | ||
Revision as of 16:24, 22 January 2022
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main medulloblastoma page for current regimens.
4 regimens on this page
5 variants on this page
|
COGACNS0331 Reduced Dose CSRT/Reduced Volume Boost to Tumor Bed
- Ages 3-7 Randomized
- All patients must begin therapy within 31 days of surgery.
Chemoradiotherapy
XRT
- Craniospinal External beam radiotherapy 18 Gy in 10 daily fractions.
- Posterior Fossa External beam radiotherapy 5.4 Gy in 3 daily fractions prior to the radiation boost.
- Tumor Bed Boost External beam radiotherapy 30.6 Gy in 17 daily fractions.
Chemotherapy
- Vincristine (Oncovin) 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute or IV infusion (per institution) once on day 8, 15, 22, 29, 36, and 43 (Once a week starting one week after CSRT begins).
- Round vincristine down to the nearest 0.1 mg.
7-week course
References
- COG ACNS0331: Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. link to original article NCT00085735
Maintenance Regimen A
Cycles 1, 2, 4, 5, 7, 8
Chemotherapy
- Cisplatin (Platinol) 75 mg/m2 IV once on day 1
- Lomustine (CCNU) 75 mg/m2 PO once on day 1 on an empty stomach (at least 2 hours after food) preferably at bedtime (reduce N/V).
- Pediatric Lomustine Dosing Chart
- Give Lomustine (CCNU) with at least 8 oz of fluids for children > 3 years old and at least 4 oz of fluids for children < 3 years of age.
- Vincristine (Oncovin) 1.5 mg/m2 (maximum dose of 2 mg) IV once per day on days 1, 8, and 15.
- Dose rounded down to the nearest 0.1 mg.
- Can be given IV push over 1-minute or by infusion via minibag as per institution policy.
6-week cycle
References
- COG ACNS0331: Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. link to original article NCT00085735
Maintenance Regimen B
Cycles 3, 6, and 9
Chemotherapy
- Cyclophosphamide (Cytoxan) 1000 mg/m2 IV given over 1 hour on Days 1 and 2.
- Mesna (Mesnex) 360 mg/m2/dose IV over 15 to 30 minutes on Days 1 and 2
- Dose given at least 15 minutes prior to or at the same time as Cyclophosphamide (Cytoxan) and repeated at 4 and 8 hours post Cyclophosphamide (Cytoxan).
- Can be given via continuous infusion starting 15-30 minutes before or at the same time as Cyclophosphamide (Cytoxan) and finished no sooner than 8 hours after the end of the Cyclophosphamide (Cytoxan) infusion.
- Vincristine (Oncovin) 1.5 mg/m2 (maximum dose of 2 mg) IV once per day on days 1, and 8.
- Dose rounded down to the nearest 0.1 mg.
- Can be given IV push over 1-minute or by infusion via minibag as per institution policy.
6-week course
References
- COG ACNS0331: Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. link to original article NCT00085735
COGACNS0331 Reduced Dose CSRT/Standard Volume Boost
- Ages 3-7
- All patients must begin therapy within 31 days of surgery.
Chemoradiotherapy
XRT
- Craniospinal External beam radiotherapy 18 Gy in 10 daily fractions.
- Posterior Fossa External beam radiotherapy 5.4 Gy in 3 daily fractions prior to the radiation boost.
- Posterior Fossa Boost External beam radiotherapy 30.6 Gy in 17 daily fractions.
Chemotherapy
- Vincristine (Oncovin) 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute or IV infusion (per institution) once on day 8, 15, 22, 29, 36, and 43 (Once a week starting one week after CSRT begins).
- Round vincristine down to the nearest 0.1 mg.
7-week course
References
- COG ACNS0331: Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. link to original article NCT00085735
Maintenance Regimen A
Cycles 1, 2, 4, 5, 7, 8
Chemotherapy
- Cisplatin (Platinol) 75 mg/m2 IV once on day 1
- Lomustine (CCNU) 75 mg/m2 PO once on day 1 on an empty stomach (at least 2 hours after food) preferably at bedtime (reduce N/V).
- Pediatric Lomustine Dosing Chart
- Give Lomustine (CCNU) with at least 8 oz of fluids for children > 3 years old and at least 4 oz of fluids for children < 3 years of age.
- Vincristine (Oncovin) 1.5 mg/m2 (maximum dose of 2 mg) IV once per day on days 1, 8, and 15.
- Dose rounded down to the nearest 0.1 mg.
- Can be given IV push over 1-minute or by infusion via minibag as per institution policy.
6-week cycle
References
- COG ACNS0331: Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. link to original article NCT00085735
Maintenance Regimen B
Cycles 3, 6, and 9
Chemotherapy
- Cyclophosphamide (Cytoxan) 1000 mg/m2 IV given over 1 hour on Days 1 and 2.
- Mesna (Mesnex) 360 mg/m2/dose IV over 15 to 30 minutes on Days 1 and 2
- Dose given at least 15 minutes prior to or at the same time as Cyclophosphamide (Cytoxan) and repeated at 4 and 8 hours post Cyclophosphamide (Cytoxan).
- Can be given via continuous infusion starting 15-30 minutes before or at the same time as Cyclophosphamide (Cytoxan) and finished no sooner than 8 hours after the end of the Cyclophosphamide (Cytoxan) infusion.
- Vincristine (Oncovin) 1.5 mg/m2 (maximum dose of 2 mg) IV once per day on days 1, and 8.
- Dose rounded down to the nearest 0.1 mg.
- Can be given IV push over 1-minute or by infusion via minibag as per institution policy.
6-week course
References
- COG ACNS0331: Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy PC, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, JBooth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy with Chemotherapy for Newly Diagnosed Average Risk Medulloblastoma. Journal of Clinical Oncology 39, no. 24 (August 20, 2021) 2685-2697. link to original article NCT00085735