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Evaluating the efficacy and safety of single-agent etoposide intra-CSF chemotherapy in children and young people with relapsed/refractory central nervous system tumours
Butler, Anna Chohan, Manjit MacArthur, Donald C. Parr, Margaret Wilne, Sophie Grundy, Richard Dandapani, Madhumita
Butler, Anna
Chohan, Manjit
MacArthur, Donald C.
Parr, Margaret
Wilne, Sophie
Grundy, Richard
Dandapani, Madhumita
Abstract
Purpose: The aim of the project was to evaluate intra-CSF etoposide administration in a palliative setting for children and young people with relapsed/refractory central nervous system (CNS) tumours, with the primary endpoints being overall survival and progression-free survival time. A safety endpoint was to assess the side effect profile and complications of intra-CSF etoposide. Method(s): Thirty-five patients under the age of 30 years (median age: 5.33 years) were enrolled onto the project. The cross-centre study was a service evaluation, with a data collection spreadsheet designed in Nottingham and completed by both Nottingham and Oxford centres. Data was analysed using SPSS, assessing the overall survival and progression-free survival times, as well as the 6-month and 1-year survival rates. Result(s): The median overall survival and progression-free survival times were 10.97 and 5.91 months, respectively. The 6-month and 1-year overall survival rates were 67% and 48%, and the progression-free survival rates were 50% and 22%. Age at the start of intra-CSF therapy was significantly associated with overall survival (P = 0.046), with the 6 + age group having improved overall survival. Treatment type was significantly associated with overall survival (P = 0.012), with etoposide intra-CSF treatment being associated with improved overall survival. Treatment duration was significantly associated with both overall survival (P < 0.001) and progression-free survival (P < 0.001). Conclusion(s): Intra-CSF etoposide treatment has shown to increase both overall and progression-free survival significantly, whilst having few side effects and maintaining a good quality of life for patients, reflecting it as a beneficial therapy in the palliative setting.Copyright © 2023, Crown.
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Date
2023
Type
Article
Subject
Child, Chemotherapy, Recurrence, Central nervous system neoplasms
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Citation
Butler, A., Meijer, L., Liu, J., Chohan, M., Jalloh, I., MacArthur, D., Parr, M., Wilne, S., Wilson, S., Walker, D., Grundy, R. and Dandapani, M. (2023) 'Evaluating the efficacy and safety of single-agent etoposide intra-CSF chemotherapy in children and young people with relapsed/refractory central nervous system tumours', Child's Nervous System, 39(6), pp. 1537–1544. doi: 10.1007/s00381-023-05872-w https://doi.org/10.1007/s00381-023-05872-w.