Nov. 6, 1997 MEMPHIS, Tenn., November 6, 1997 -- Doctors at St. Jude Children's Research Hospital today announced new brain tumor research protocols they hope will improve survival rates and reduce side effects of radiation therapy among pediatric cancer patients.
The protocols rely on three dimensional imaging (CT imaging or MR imaging) to define and target tumors more accurately. Not only is a lower radiation dose to normal tissue made possible, but treatment of sensitive areas of the brain is more easily avoided.
"Because these children will undergo extensive testing prior to radiation therapy to identify side effects caused by the tumor, surgery, or other causes, this study will help us identify which side effects are specifically caused by radiation," says Thomas E. Merchant, D.O., Ph.D., Clinical Director in the Department of Radiation Oncology at St. Jude Children's Research Hospital.
"We'll also determine more precisely the amount of radiation that causes a particular side effect and improve our ability to decrease or avoid radiation-related side effects altogether, " added Dr. Merchant.
Radiation therapy is a first-line treatment for primary brain tumors, which comprise more than half of the central nervous system tumors in children. Unfortunately, radiation therapy is associated with severe side effects, including behavioral problems, decreased IQ, decreased growth and development, and hearing loss.
Because some of these problems may in fact be due to the brain tumor, the investigators have planned extensive endocrine, psychological, and other testing for these patients which should reveal new knowledge about the effects of tumors on children.
One of the protocols specifically addresses the second most common childhood brain tumor type, medulloblastoma, and also involves the use of anticancer drugs.
"By giving average risk patients reduced dose radiation more precisely, and high dose chemotherapy with therapy to hasten the recovery of bone marrow cells, we hope to increase the number of patients who survive and to reduce side-effects like learning difficulties, hearing loss and endocrine problems," says Amar Gajjar, M.D., a member of the Division of Neuro-Oncology at St. Jude Children's Research Hospital.
"For the high risk patients, we will treat them with a promising new drug, called topotecan, followed by the same precise standard dose radiation therapy and high dose chemotherapy. We hope this combination of therapies will increase survival rates and reduce side effects."
Like the radiation therapy, the chemotherapy used in this study will be given to patients in a unique manner. All patients will receive four courses of high dose chemotherapy using drugs which are very effective in treating this tumor. Following each course of chemotherapy, the patients will receive special therapy to help restore their bone marrow, and which will allow them to receive chemotherapy on an optimal timetable of every four weeks.
Patient enrollment for studies involving both protocols is underway. All costs of treatment beyond those reimbursed by third party insurers, and total costs for families who have no insurance, will be covered.
To be eligible for enrollment in the study involving medulloblastoma, patients must be at least three years old, have medulloblastoma and have received no prior radiation therapy and chemotherapy. Patients who have received surgery without radiation therapy or chemotherapy can be enrolled provided they can start the protocol no more than 28 days after surgery.
To be eligible for the protocol involving radiation therapy targeting, patients must be at least 18 months old, have a primary brain tumor that requires only focal irradiation, and have had no prior radiation therapy. Patients who have received or will receive surgery and chemotherapy can be enrolled.
St. Jude Children's Research Hospital, in Memphis, Tenn., was founded by the late entertainer Danny Thomas. The hospital is an internationally recognized biomedical research center dedicated to finding cures for catastrophic diseases of childhood. The hospital's work is primarily supported through funds raised by the American Lebanese Syrian Associated Charities (ALSAC).
All St. Jude patients are treated regardless of their ability to pay. ALSAC covers all costs of treatment beyond those reimbursed by third party insurers, and total costs for families who have no insurance.
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