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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5
|
| pubmed:dateCreated |
1984-4-16
|
| pubmed:abstractText |
During the period 1976-1981, 3241 children were enrolled on three major studies of acute lymphoblastic leukemia by participating institutions of the Children's Cancer Study Group. Each study included a different method of central nervous system (CNS) prophylaxis: (1) standard therapy with cranial irradiation, 2400 rads, and intrathecal methotrexate at 12 mg/m2 six times during consolidation (CCG-141); (2) a modification of CCG-141 in which the intrathecal methotrexate was initiated during induction (CCG-141A); and (3) a reduced cranial irradiation dose of 1800 rads with intrathecal methotrexate given at the same frequency as a CCG-141A, with or without maintenance intrathecal methotrexate, but with a dosage regimen derived from CNS volume considerations rather than based on body surface area (CCG-160 series). Strategy 3, a change in the intrathecal methotrexate dosage, has resulted in the lowest incidence of CNS leukemia to date (p less than 0.007). The cumulative 3-yr CNS relapse rate has decreased from 8%-10% to 2%-5% in average-risk patients (p less than 0.02; life table estimate) and from 23%-27% to 6% in high-risk patients (p less than 0.0002; life table estimate), despite a reduction in the cranial irradiation dose from 2400 to 1800 rads. Maintenance intrathecal chemotherapy has had a marginal effect among patients randomized to receive this additional therapy (p = 0.06). The overall outcome has been an increase in the continuous complete remission rate (p = 0.04) but not in the estimated 3-yr continuous hematologic remission or survival rates.
|
| pubmed:grant | |
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
May
|
| pubmed:issn |
0732-183X
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
1
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
N
|
| pubmed:pagination |
317-25
|
| pubmed:dateRevised |
2007-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:6366138-Acute Disease,
pubmed-meshheading:6366138-Adolescent,
pubmed-meshheading:6366138-Age Factors,
pubmed-meshheading:6366138-Antineoplastic Combined Chemotherapy Protocols,
pubmed-meshheading:6366138-Brain Neoplasms,
pubmed-meshheading:6366138-Child,
pubmed-meshheading:6366138-Child, Preschool,
pubmed-meshheading:6366138-Clinical Trials as Topic,
pubmed-meshheading:6366138-Combined Modality Therapy,
pubmed-meshheading:6366138-Drug Administration Schedule,
pubmed-meshheading:6366138-Humans,
pubmed-meshheading:6366138-Infant,
pubmed-meshheading:6366138-Injections, Spinal,
pubmed-meshheading:6366138-Leukemia, Lymphoid,
pubmed-meshheading:6366138-Methotrexate,
pubmed-meshheading:6366138-Random Allocation,
pubmed-meshheading:6366138-Spinal Cord Neoplasms,
pubmed-meshheading:6366138-Time Factors
|
| pubmed:year |
1983
|
| pubmed:articleTitle |
Reduction in central nervous system leukemia with a pharmacokinetically derived intrathecal methotrexate dosage regimen.
|
| pubmed:publicationType |
Journal Article,
Clinical Trial,
Comparative Study,
Research Support, U.S. Gov't, P.H.S.,
Randomized Controlled Trial,
Research Support, Non-U.S. Gov't
|