PRESYMPTOMATIC CENTRAL NERVOUS SYSTEM THERAPY IN PREVIOUSLY UNTREATED CHILDHOOD ACUTE LYMPHOBLASTIC LEUKAEMIA: COMPARISON OF 1800 RAD AND 2400 RAD A Report for Children's Cancer Study Group
PRESYMPTOMATIC CENTRAL NERVOUS SYSTEM THERAPY IN PREVIOUSLY UNTREATED CHILDHOOD ACUTE LYMPHOBLASTIC LEUKAEMIA: COMPARISON OF 1800 RAD AND 2400 RAD A Report for Children's Cancer Study Group
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先前未经治疗的儿童急性淋巴细胞白血病的症状前中枢神经系统治疗：1800 RAD 和 2400 RAD 的比较儿童癌症研究组的报告
DOI：
10.1016/s0140-6736(81)91849-3
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发表时间：
1981
期刊：
影响因子：
--
通讯作者：
G. Hammond
中科院分区：
文献类型：
--
作者：
M. Nesbit;L. Robison;P. Littman;H. Sather;J. Ortega;G. D'Angio;G. Hammond
儿童癌症研究小组组织了两项治疗性临床试验，旨在评估各种类型和剂量的中枢神经系统预防治疗儿童急性淋巴细胞白血病的疗效。在478名先前未经治疗的患者中，299名随后获得初始骨髓缓解，随机接受2400 rad颅脊髓放射治疗（RT）或2400 rad颅RT加鞘内甲氨蝶呤（i.t. MTX），而其余179名患者随机分配在相同的两种方案之间，使用1800拉德的辐射剂量。所有患者均接受相同的诱导和维持化疗。两项研究的比较表明，减少剂量的中枢神经系统辐射从2400拉德至1800拉德并没有导致中枢神经系统复发，骨髓复发，或死亡的频率显着增加。此外，在预后风险组内进行分析时，未观察到显著差异。RT剂量低于1800 rad或i.t.应考虑单独化疗以确定最有效和毒性最小的CNS预防形式。
The Children's Cancer Study Group has organised two therapeutic clinical trials designed to evaluate the efficacy of various types and doses of CNS prophylaxis in the treatment of childhood acute lymphoblastic leukaemia. Of 478 previously untreated patients who subsequently achieved an initial marrow remission, 299 were randomised to receive 2400 rad craniospinal radiation therapy (RT) or 2400 rad cranial RT plus intrathecal methotrexate (i.t. MTX) while the remaining 179 patients were randomised between the same two regimens using a radiation dose of 1800 rad. All patients received identical induction and maintenance chemotherapy. Comparison of the two studies indicated that reduction of the dose of CNS radiation from 2400 rad to 1800 rad did not result in a significant increase in the frequency of CNS relapse, bone marrow relapse, or death. Moreover, no significant differences were observed when analyses were done within prognostic risk groups. Randomised trials with RT doses lower than 1800 rad or with i.t. chemotherapy alone should be considered to determine the most effective and least toxic forms of CNS prophylaxis.