Toxicities associated with chemotherapy followed by craniospinal radiation for adults with poor-risk medulloblastoma/PNET and disseminated ependymoma; a preliminary report of ECOG 4397

1573 Background: The treatment of poor-risk medulloblastoma (MED) in adults derives from results in children indicating improved survival with combined modality therapy. In adults, chemotherapy is limited by hematological toxicities when given after craniospinal radiation. ECOG 4397 is designed to assess the toxicities, response rate, and long-term control in poor-risk patients treated with multi-agent chemotherapy prior to craniospinal radiation. This trial represents the collaborative efforts of ECOG and SWOG participants. Methods: Patients greater than 18 years with: 1) poor-risk MED/PNET, or 2) ependymoma with subarachnoid metastases were treated with three cycles of cisplatin (70 mg/m2, day 1), cyclophosphamide (700 mg/m2/d, day 2–3), etoposide (70 mg/m2, days 1–3), and vincristine (1.5 mg/m2 up to 2 mg, days 1 and 14) every 4 weeks. G-CSF was used. Radiation included 36 Gy to the craniospinal axis followed by a boost to 54 Gy to the primary site. MRI scans were performed after each cycle to monitor ...