Chemotherapy of recurrent medulloblastoma with combined procarbazine, CCNU, and vincristine

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  • 1 Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California
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✓ Seventeen patients with recurrent medulloblastoma were treated with a combination of three drugs: procarbazine, CCNU, and vincristine (PCV). Tumor recurrence was documented at varying periods following surgery and radiotherapy. Among 16 evaluable patients, ten showed a response to PCV on the basis of subjective neurological improvement and a decrease in tumor size by radiological criteria. Five patients were designated as having stable disease on the basis of no change in neurological status and tumor size. One patient showed uninterrupted progression of disease. The median time to progression for all patients was 45 weeks.

Significant myelotoxicity, exacerbated by prior spinal irradiation, compromised therapy. After an initial response, it was often necessary to reduce the higher doses of CCNU and procarbazine that caused concomitant bone-marrow toxicity; as a consequence of the lowered doses, tumor progression was then frequently observed. The authors conclude that PCV is an effective form of palliative therapy for recurrent medulloblastoma.

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Contributor Notes

Address for Dr. Crafts: Division of Neurological Surgery, Department of Surgery, St. Louis University School of Medicine, St. Louis, Missouri 63110.Address reprint requests to: Neurosurgery Editorial Office, 350 Parnassus Avenue, Suite 807, University of California, San Francisco, California 94143.
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