PURPOSE: To determine whether preradiotherapy ( @entity138 ) chemotherapy would improve outcome for Chang stage M0-1 @entity2946 when compared with @entity138 alone. Chemotherapy comprised @entity1891 1.5 mg/m2 weekly for 10 weeks and four cycles of @entity2879 100 mg/m2 daily for 3 days, and @entity3003 500 mg/m2 daily for 2 days alternating with @entity786 1.5 g/m2. @entity1 AND METHODS: @entity1 aged 3 to 16 years inclusive were randomly assigned to receive 35 Gy craniospinal @entity138 with a 20 Gy posterior fossa boost, or chemotherapy followed by @entity138 . RESULTS: Of 217 @entity1 randomly assigned to treatment, 179 were eligible for analysis (chemotherapy + @entity138 , 90 @entity1 ; @entity138 alone, 89 @entity1 ). Median age was 7.67 years, and median follow-up was 5.40 years. Overall survival (OS) at 3 and 5 years was 79.5% and 70.7%, respectively. Event-free survival (EFS) at 3 and 5 years was 71.6% and 67.0%, respectively. EFS was significantly better for chemotherapy and @entity138 (P =.0366), with EFS of 78.5% at 3 years and 74.2% at 5 years compared with 64.8% at 3 years and 59.8% at 5 years for @entity138 alone. There was no statistically significant difference in 3-year and 5-year OS between the two arms (P =.0928). Multivariate analysis identified use of chemotherapy (P =.0248) and time to complete @entity138 (P =.0100) as having significant effect on EFS. CONCLUSION: This is the first large multicenter randomized study to demonstrate improved EFS for chemotherapy compared with @entity138 alone. It is anticipated that this regimen could reduce @entity2167 and nephrotoxicity compared with @entity900 -containing schedules. The importance of avoiding interruptions to @entity138 has been confirmed.

Results of a randomized study of preradiation chemotherapy versus radiotherapy alone for nonmetastatic @entity2946 : The International Society of Paediatric Oncology/United Kingdom XXXX 's Cancer Study Group PNET-3 Study.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity2167 :: ('MESH:D006311', 'Disease') :: ['ototoxicity'] @entity138 :: ('MESH:C563738', 'Disease') :: ['RT'] @entity3003 :: ('MESH:D016190', 'Chemical') :: ['carboplatin'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity786 :: ('MESH:D003520', 'Chemical') :: ['cyclophosphamide'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['etoposide'] @entity1891 :: ('MESH:D014750', 'Chemical') :: ['vincristine'] @entity2946 :: ('MESH:D008527', 'Disease') :: ['medulloblastoma']
@entity1 :: (9606,Species) :: ['Children']
