PDF(Pubmed)
Abstract：
UNASSIGNED: SIOP-CNS-GCT-II European trial was opened for the treatment of patients of any age with central nervous system germ cell tumour (CNS-GCT). Four courses of pre-irradiation chemotherapy were delivered. The influence of patient age on chemotherapy related acute toxicity (CRAT) was assessed.
UNASSIGNED: CRAT was analysed according to age-groups: children (aged ≤11 years), adolescents (aged 12-17 years), adults (aged ≥18 years) and to chemotherapy type: CarboPEI (alternating etoposide-carboplatin/etoposide-ifosfamide) for non-metastatic germinoma; PEI (cisplatin-etoposide-ifosfamide) for standard-risk non-germinomatous GCT (NGGCT); PEI and high-dose PEI (HD-PEI), for high-risk or poorly responsive NGGCTs.
UNASSIGNED: 296 patients were assessable for CRAT: 105 children, 121 adolescents, 70 adults (max age: 41 years). Median cumulative doses/m² of chemotherapy were similar among age-groups. The proportion of germinoma over NGGCT (and accordingly use of CarboPEI chemotherapy) was higher in the adult groups (79%) versus the other two groups (62%). Delay in chemotherapy ≥7 days was noticed in 27%, 38%, and 19% of children, adolescents, and adults, respectively. Grade ≥3 haematological and non-haematological adverse events (AEs) were observed in 94%/31%, 97%/36%, and 77%/21% of children, adolescents, and adults, respectively. No toxic death was reported. Grade ≥3 AEs and delayed chemotherapies were significantly rarer in adults when compared with adolescents, even when adjusted on chemotherapy type: odds ratio: 0.1 [95%CI 0.02-0.4], and 0.2 [95%CI 0.1-0.4] in the group treated with CarboPEI.
UNASSIGNED: Adult patients can be treated safely with a chemotherapy intensive protocol, with even less toxicity than that observed in adolescents. Further work is required to understand age-related differences regarding toxicity.
UNASSIGNED: CRAT was analysed according to age-groups: children (aged ≤11 years), adolescents (aged 12-17 years), adults (aged ≥18 years) and to chemotherapy type: CarboPEI (alternating etoposide-carboplatin/etoposide-ifosfamide) for non-metastatic germinoma; PEI (cisplatin-etoposide-ifosfamide) for standard-risk non-germinomatous GCT (NGGCT); PEI and high-dose PEI (HD-PEI), for high-risk or poorly responsive NGGCTs.
UNASSIGNED: 296 patients were assessable for CRAT: 105 children, 121 adolescents, 70 adults (max age: 41 years). Median cumulative doses/m² of chemotherapy were similar among age-groups. The proportion of germinoma over NGGCT (and accordingly use of CarboPEI chemotherapy) was higher in the adult groups (79%) versus the other two groups (62%). Delay in chemotherapy ≥7 days was noticed in 27%, 38%, and 19% of children, adolescents, and adults, respectively. Grade ≥3 haematological and non-haematological adverse events (AEs) were observed in 94%/31%, 97%/36%, and 77%/21% of children, adolescents, and adults, respectively. No toxic death was reported. Grade ≥3 AEs and delayed chemotherapies were significantly rarer in adults when compared with adolescents, even when adjusted on chemotherapy type: odds ratio: 0.1 [95%CI 0.02-0.4], and 0.2 [95%CI 0.1-0.4] in the group treated with CarboPEI.
UNASSIGNED: Adult patients can be treated safely with a chemotherapy intensive protocol, with even less toxicity than that observed in adolescents. Further work is required to understand age-related differences regarding toxicity.
摘要：
■SIOP-CNS-GCT-II欧洲试验已开始，用于治疗任何年龄的中枢神经系统生殖细胞肿瘤（CNS-GCT）患者。进行了四个疗程的放射前化疗。评估了患者年龄对化疗相关急性毒性（CRAT）的影响。
■根据年龄组对CRAT进行分析：儿童（≤11岁），青少年（12-17岁），成人（≥18岁）和化疗类型：非转移性生殖细胞瘤的CarboPEI（交替使用依托泊苷-卡铂/依托泊苷-异环磷酰胺）；标准风险非生殖细胞瘤GCT（NGGCT）的PEI（顺铂-依托泊苷-异环磷酰胺）；PEI和高剂量PEI（HD-PEI），用于高风险或反应不佳的NGGCT。
■296名患者可进行CRAT评估：105名儿童，121名青少年，70名成年人（最大年龄：41岁）。在年龄组中，平均累积剂量/m²的化疗剂量相似。成人组（79％）与其他两组（62％）相比，NGGCT（因此使用CarboPEI化疗）的生殖细胞瘤比例更高。27％的人发现化疗延迟≥7天，38%,19%的儿童，青少年,和成年人，分别。在94%/31%中观察到≥3级血液学和非血液学不良事件(AE),97%/36%，77%/21%的儿童，青少年,和成年人，分别。没有中毒死亡的报告。与青少年相比，成人≥3级AE和延迟化疗明显罕见，即使根据化疗类型进行调整：比值比：0.1[95CI0.02-0.4]，和0.2[95CI0.1-0.4]在用CarboPEI治疗的组中。
■成年患者可以通过化疗强化方案安全治疗，毒性甚至比在青少年中观察到的更小。需要进一步的工作来了解与年龄有关的毒性差异。
■根据年龄组对CRAT进行分析：儿童（≤11岁），青少年（12-17岁），成人（≥18岁）和化疗类型：非转移性生殖细胞瘤的CarboPEI（交替使用依托泊苷-卡铂/依托泊苷-异环磷酰胺）；标准风险非生殖细胞瘤GCT（NGGCT）的PEI（顺铂-依托泊苷-异环磷酰胺）；PEI和高剂量PEI（HD-PEI），用于高风险或反应不佳的NGGCT。
■296名患者可进行CRAT评估：105名儿童，121名青少年，70名成年人（最大年龄：41岁）。在年龄组中，平均累积剂量/m²的化疗剂量相似。成人组（79％）与其他两组（62％）相比，NGGCT（因此使用CarboPEI化疗）的生殖细胞瘤比例更高。27％的人发现化疗延迟≥7天，38%,19%的儿童，青少年,和成年人，分别。在94%/31%中观察到≥3级血液学和非血液学不良事件(AE),97%/36%，77%/21%的儿童，青少年,和成年人，分别。没有中毒死亡的报告。与青少年相比，成人≥3级AE和延迟化疗明显罕见，即使根据化疗类型进行调整：比值比：0.1[95CI0.02-0.4]，和0.2[95CI0.1-0.4]在用CarboPEI治疗的组中。
■成年患者可以通过化疗强化方案安全治疗，毒性甚至比在青少年中观察到的更小。需要进一步的工作来了解与年龄有关的毒性差异。
