Your browser doesn't support javascript.
loading
Comparison of intermediate-dose methotrexate with cranial irradiation for the post-induction treatment of acute lymphocytic leukemia in children.
N Engl J Med ; 308(9): 477-84, 1983 Mar 03.
Article en En | MEDLINE | ID: mdl-6571946
ABSTRACT
We compared two regimens with respect to their ability to prolong disease-free survival in 506 children and adolescents with acute lymphocytic leukemia. All responders to induction therapy were randomized to treatment with 2400 rad of cranial irradiation plus intrathecal methotrexate or to treatment with intermediate-dose methotrexate plus intrathecal methotrexate, as prophylaxis for involvement of the central nervous system and other "sanctuary" areas. Patients were then treated with a standard maintenance regimen. Complete responders were stratified into either standard-risk or increased-risk groups on the basis of age and white-cell count at presentation. Among patients with standard risk, hematologic relapses occurred in 9 of 117 given methotrexate and 24 of 120 given irradiation (P less than 0.01). The rate of central-nervous-system relapse was higher in the methotrexate group (23 of 117) than in the irradiation group (8 of 120) (P = 0.01). Among patients with increased risk, radiation offered greater protection to the central nervous system than methotrexate (P = 0.03); there was no difference in the rate of hematologic relapse. In both risk strata the frequency of testicular relapse was significantly lower in the methotrexate group (1 patient) than the radiation group (10 patients) (P = 0.01). Methotrexate offered better protection against systemic relapse in standard-risk patients and better protection against testicular relapse overall, but it offered less protection against relapses in the central nervous system than cranial irradiation.
Asunto(s)
Buscar en Google
Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 2_ODS3 Problema de salud: 2_muertes_prematuras_enfermedades_notrasmisibles Asunto principal: Encéfalo / Leucemia Linfoide / Metotrexato Tipo de estudio: Clinical_trials Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: N Engl J Med Año: 1983 Tipo del documento: Article
Buscar en Google
Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 2_ODS3 Problema de salud: 2_muertes_prematuras_enfermedades_notrasmisibles Asunto principal: Encéfalo / Leucemia Linfoide / Metotrexato Tipo de estudio: Clinical_trials Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: N Engl J Med Año: 1983 Tipo del documento: Article
...