A multimodal strategy based on surgery, radiotherapy, ICE regimen and high dose chemotherapy in atypical teratoid/rhabdoid tumours: a single institution experience

J Neurooncol. 2009 Apr;92(2):177-83. doi: 10.1007/s11060-008-9750-y. Epub 2008 Nov 29.

Abstract

Purpose: Atypical Teratoid/Rhabdoid Tumour is a rare and aggressive childhood tumour. The outcome of a series treated with the same multimodal strategy was reported.

Patients: The patients were treated with surgery, 2 courses of ifosfamide/carboplatin/etoposide(ICE), 2 courses of cyclophosphamide/etoposide/carboplatino/thiotepa (CECAT) or 2 other ICE courses, high dose chemotherapy (HDC) and radiotherapy.

Results: Eight patients underwent primary surgery achieving a complete removal in 3. Progressive disease (PD) occurred in 2/8 patients during ICE courses and in 3/4 during CECAT courses. After 4 courses 5 patients presented a PD. HDC was performed in 3 patients followed by local radiotherapy. The Kaplan Meier OS and EFS probability at 5 years are, respectively, 50% (CI 11-80%) and 33% (CI 6-66%).

Conclusion: A strategy based on surgery, including a second surgical look, and on radiotherapy appears the best option. ICE regimen and HDC correlate with good prognosis in some patients but this approach needs further evaluation.

Publication types

  • Clinical Trial

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brain Neoplasms / therapy*
  • Carboplatin / administration & dosage
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Etoposide / administration & dosage
  • Female
  • Humans
  • Ifosfamide / administration & dosage
  • Infant
  • Kaplan-Meier Estimate
  • Magnetic Resonance Imaging
  • Male
  • Neurosurgical Procedures
  • Radiotherapy
  • Rhabdoid Tumor / mortality
  • Rhabdoid Tumor / therapy*
  • Teratoma / mortality
  • Teratoma / therapy*
  • Thiotepa / administration & dosage
  • Tomography, X-Ray Computed

Substances

  • Etoposide
  • Cyclophosphamide
  • Thiotepa
  • Carboplatin
  • Ifosfamide